Agents for pain and agitation control and risk for death in patients with pulmonary tuberculosis infection requiring long-term mechanical ventilation
Abstract
BACKGROUND
To identify the association between agents for pain and agitation control and risk for death in patients with pulmonary tuberculosis infection requiring long-term mechanical ventilation
METHODS
We conducted a retrospective cohort study of those with PTB infection requiring long-term mechanical ventilation admitted at Khon Kaen Hospital, Thailand. The agents for pain and agitation control were our interested exposure. Our primary outcome was the all-cause mortality within 90 days of admission. Our secondary outcomes included cardiac arrest, ventilator-associated pneumonia, acute respiratory distress syndrome (ARDS), shock, tracheostomy, and barotrauma.
RESULTS
Among 393 patients with PTB infection requiring long-term mechanical ventilation between January 2013 and August 2017. We found that the use of the agents for pain and agitation control were not significantly associated with the all-cause mortality within 90 days of admission (crude hazard ratio (HR), 0.98; 95% confidence interval [CI], 0.77 to 1.24; adjusted HR, 1.08; 95% CI, 0.84 to 1.39)). For the secondary outcomes, the use of the agents were not significantly associated with cardiac arrest (relative risk [RR], 1.47; 95% CI 0.99 to 2.19), ventilator-associated pneumonia (RR, 1.86; 95% CI 0.58 to 6.00), ARDS (RR, 3.10; 95% CI 0.28 to 33.94), shock (RR, 0.91; 95% CI 0.76 to 1.09) and barotrauma. However, we found the use of the agents was significantly associated with the tracheostomy (RR, 7.05; 95% CI 1.43 to 34.66).
CONCLUSIONS
The exposure to the agents for pain and agitation control were not significantly associated with all-cause mortality within 90 days of admission in patients with PTB infection requiring long-term mechanical ventilation.
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