The effect of dobutamine in sepsis: a propensity score matched analysis

Abstract Background The use of dobutamine in patients with sepsis is questionable currently. As the benefit of dobutamine in septic patients is unclear, we aimed to evaluate whether the use of dobutamine was associated with decreased hospital mortality in sepsis patients. Methods Based on the analys...

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Autores principales:	Youfeng Zhu, Haiyan Yin, Rui Zhang, Xiaoling Ye, Jianrui Wei
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Dobutamine Sepsis Propensity score matched analysis Hospital mortality Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/ae19959d98ed4ff690a1aee6587a7f70
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spelling	oai:doaj.org-article:ae19959d98ed4ff690a1aee6587a7f702021-11-14T12:44:22ZThe effect of dobutamine in sepsis: a propensity score matched analysis10.1186/s12879-021-06852-81471-2334https://doaj.org/article/ae19959d98ed4ff690a1aee6587a7f702021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06852-8https://doaj.org/toc/1471-2334Abstract Background The use of dobutamine in patients with sepsis is questionable currently. As the benefit of dobutamine in septic patients is unclear, we aimed to evaluate whether the use of dobutamine was associated with decreased hospital mortality in sepsis patients. Methods Based on the analysis of MIMIC III public database, we performed a big-data, real world study. According to the use of dobutamine or not, patients were categorized as the dobutamine group or non dobutamine group.We used propensity score matched (PSM) analysis to adjust for confoundings. The primary outcome was hospital mortality. Results In the present study, after screening 38,605 patients, 2826 patients with sepsis were included. 121 patients were in dobutamine group and 2165 patients were in non dobutamine group. Compared with patients in non-dobutamine group, patients in dobutamine group had a lower MAP, higher HR, higher RR, higher severity of illness scores. 72 of 121 patients (59.5%) in the dobutamine group and 754 of 2165 patients (34.8%) in the non-dobutamine group died in the hospital, which resulted in a significant between-group difference (OR 1.56, 95% CI 1.01–2.40; P = 0.000). For the secondary outcomes, patients in dobutamine group received more MV use, more renal replacement therapy use, had longer ICU stay durations and more cardiac arrhythmias than those in non-dobutamine group. After adjusting for confoundings between groups by PSM analysis, hospital mortality was consistently higher in dobutamine group than that in non-dobutamine group (60.2% vs. 49.4%, OR 1.55, 95% CI 1.01–2.37; P = 0.044). Conclusions Among patients with sepsis, our study showed that the use of dobutamine was not associated with decreased hospital mortality. Further large scale, randomized controlled studies are warrented to confirm our findings.Youfeng ZhuHaiyan YinRui ZhangXiaoling YeJianrui WeiBMCarticleDobutamineSepsisPropensity score matched analysisHospital mortalityInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dobutamine Sepsis Propensity score matched analysis Hospital mortality Infectious and parasitic diseases RC109-216
spellingShingle	Dobutamine Sepsis Propensity score matched analysis Hospital mortality Infectious and parasitic diseases RC109-216 Youfeng Zhu Haiyan Yin Rui Zhang Xiaoling Ye Jianrui Wei The effect of dobutamine in sepsis: a propensity score matched analysis
description	Abstract Background The use of dobutamine in patients with sepsis is questionable currently. As the benefit of dobutamine in septic patients is unclear, we aimed to evaluate whether the use of dobutamine was associated with decreased hospital mortality in sepsis patients. Methods Based on the analysis of MIMIC III public database, we performed a big-data, real world study. According to the use of dobutamine or not, patients were categorized as the dobutamine group or non dobutamine group.We used propensity score matched (PSM) analysis to adjust for confoundings. The primary outcome was hospital mortality. Results In the present study, after screening 38,605 patients, 2826 patients with sepsis were included. 121 patients were in dobutamine group and 2165 patients were in non dobutamine group. Compared with patients in non-dobutamine group, patients in dobutamine group had a lower MAP, higher HR, higher RR, higher severity of illness scores. 72 of 121 patients (59.5%) in the dobutamine group and 754 of 2165 patients (34.8%) in the non-dobutamine group died in the hospital, which resulted in a significant between-group difference (OR 1.56, 95% CI 1.01–2.40; P = 0.000). For the secondary outcomes, patients in dobutamine group received more MV use, more renal replacement therapy use, had longer ICU stay durations and more cardiac arrhythmias than those in non-dobutamine group. After adjusting for confoundings between groups by PSM analysis, hospital mortality was consistently higher in dobutamine group than that in non-dobutamine group (60.2% vs. 49.4%, OR 1.55, 95% CI 1.01–2.37; P = 0.044). Conclusions Among patients with sepsis, our study showed that the use of dobutamine was not associated with decreased hospital mortality. Further large scale, randomized controlled studies are warrented to confirm our findings.
format	article
author	Youfeng Zhu Haiyan Yin Rui Zhang Xiaoling Ye Jianrui Wei
author_facet	Youfeng Zhu Haiyan Yin Rui Zhang Xiaoling Ye Jianrui Wei
author_sort	Youfeng Zhu
title	The effect of dobutamine in sepsis: a propensity score matched analysis
title_short	The effect of dobutamine in sepsis: a propensity score matched analysis
title_full	The effect of dobutamine in sepsis: a propensity score matched analysis
title_fullStr	The effect of dobutamine in sepsis: a propensity score matched analysis
title_full_unstemmed	The effect of dobutamine in sepsis: a propensity score matched analysis
title_sort	effect of dobutamine in sepsis: a propensity score matched analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ae19959d98ed4ff690a1aee6587a7f70
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The effect of dobutamine in sepsis: a propensity score matched analysis

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