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Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study
Objective To examine the relation between the type of stress ulcer prophylaxis administered and the risk of postoperative pneumonia in patients undergoing coronary artery bypass grafting. Design Retrospective cohort study. Setting Premier Research Database. Participants: 21 214 patients undergoing c...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777797/ https://www.ncbi.nlm.nih.gov/pubmed/24052582 http://dx.doi.org/10.1136/bmj.f5416 |
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author | Bateman, Brian T Bykov, Katsiaryna Choudhry, Niteesh K Schneeweiss, Sebastian Gagne, Joshua J Polinski, Jennifer M Franklin, Jessica M Doherty, Michael Fischer, Michael A Rassen, Jeremy A |
author_facet | Bateman, Brian T Bykov, Katsiaryna Choudhry, Niteesh K Schneeweiss, Sebastian Gagne, Joshua J Polinski, Jennifer M Franklin, Jessica M Doherty, Michael Fischer, Michael A Rassen, Jeremy A |
author_sort | Bateman, Brian T |
collection | PubMed |
description | Objective To examine the relation between the type of stress ulcer prophylaxis administered and the risk of postoperative pneumonia in patients undergoing coronary artery bypass grafting. Design Retrospective cohort study. Setting Premier Research Database. Participants: 21 214 patients undergoing coronary artery bypass graft surgery between 2004 and 2010; 9830 (46.3%) started proton pump inhibitors and 11 384 (53.7%) started H(2) receptor antagonists in the immediate postoperative period. Main outcome measure Occurrence of postoperative pneumonia, assessed using appropriate diagnostic codes. Results Overall, 492 (5.0%) of the 9830 patients receiving a proton pump inhibitor and 487 (4.3%) of the 11 384 patients receiving an H(2) receptor antagonist developed postoperative pneumonia during the index hospital admission. After propensity score adjustment, an elevated risk of pneumonia associated with treatment with proton pump inhibitors compared with H(2) receptor antagonists remained (relative risk 1.19, 95% confidence interval 1.03 to 1.38). In the instrumental variable analysis, use of a proton pump inhibitor (compared with an H(2) receptor antagonist) was associated with an increased risk of pneumonia of 8.2 (95% confidence interval 0.5 to 15.9) cases per 1000 patients. Conclusions Patients treated with proton pump inhibitors for stress ulcer had a small increase in the risk of postoperative pneumonia compared with patients treated with H(2) receptor antagonists; this risk remained after confounding was accounted for using multiple analytic approaches. |
format | Online Article Text |
id | pubmed-3777797 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-37777972013-09-20 Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study Bateman, Brian T Bykov, Katsiaryna Choudhry, Niteesh K Schneeweiss, Sebastian Gagne, Joshua J Polinski, Jennifer M Franklin, Jessica M Doherty, Michael Fischer, Michael A Rassen, Jeremy A BMJ Research Objective To examine the relation between the type of stress ulcer prophylaxis administered and the risk of postoperative pneumonia in patients undergoing coronary artery bypass grafting. Design Retrospective cohort study. Setting Premier Research Database. Participants: 21 214 patients undergoing coronary artery bypass graft surgery between 2004 and 2010; 9830 (46.3%) started proton pump inhibitors and 11 384 (53.7%) started H(2) receptor antagonists in the immediate postoperative period. Main outcome measure Occurrence of postoperative pneumonia, assessed using appropriate diagnostic codes. Results Overall, 492 (5.0%) of the 9830 patients receiving a proton pump inhibitor and 487 (4.3%) of the 11 384 patients receiving an H(2) receptor antagonist developed postoperative pneumonia during the index hospital admission. After propensity score adjustment, an elevated risk of pneumonia associated with treatment with proton pump inhibitors compared with H(2) receptor antagonists remained (relative risk 1.19, 95% confidence interval 1.03 to 1.38). In the instrumental variable analysis, use of a proton pump inhibitor (compared with an H(2) receptor antagonist) was associated with an increased risk of pneumonia of 8.2 (95% confidence interval 0.5 to 15.9) cases per 1000 patients. Conclusions Patients treated with proton pump inhibitors for stress ulcer had a small increase in the risk of postoperative pneumonia compared with patients treated with H(2) receptor antagonists; this risk remained after confounding was accounted for using multiple analytic approaches. BMJ Publishing Group Ltd. 2013-09-19 /pmc/articles/PMC3777797/ /pubmed/24052582 http://dx.doi.org/10.1136/bmj.f5416 Text en © Bateman et al 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/. |
spellingShingle | Research Bateman, Brian T Bykov, Katsiaryna Choudhry, Niteesh K Schneeweiss, Sebastian Gagne, Joshua J Polinski, Jennifer M Franklin, Jessica M Doherty, Michael Fischer, Michael A Rassen, Jeremy A Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study |
title | Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study |
title_full | Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study |
title_fullStr | Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study |
title_full_unstemmed | Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study |
title_short | Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study |
title_sort | type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777797/ https://www.ncbi.nlm.nih.gov/pubmed/24052582 http://dx.doi.org/10.1136/bmj.f5416 |
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