SESSION TITLE: Chest Infections Posters I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: Calcium channel blockers(CCBs) have been shown to decrease overall mortality in septic animal models. However, to our best knowledge, no study had been conducted in human subjects to asses their impact in sepsis. Here we investigated the potential protective effect of pre-hospital CCB use against severe sepsis in patients with pneumonia.
METHODS: Retrospective study of hospitalized patients with diagnosis code of 481, 482, 485 or 486 from the year of 2012 to 2014. Patient data were extracted from the EPIC electronic database.Chest radiography and clinical presentation were reviewed for the presence of clinically compatible pneumonia at the first 72 hours of admission. Certain inclusion and exclusion criteria were applied. Continuous outcomes were analyzed by multivariate analysis of variance and dichotomous outcomes by logistic regression.
RESULTS: RESULTS: Total 2214 patients were admitted with pneumonia during this period of time. Among total 2214 patients, 1230 patients were included into the study, of which included 373 CCB users and 857 non-CCB users. After adjusting age, gender, statin use and Charleston Comorbidity Index (CCI), our study revealed CCB use was associated with less severity of disease on arrival by pneumonia severity scores(Standardized Coefficients β(β) of -0.135, p<0.05). Meanwhile, there was a significant difference in the Length of Stay (LOS) between CCB group and non-CCB group (β -0.119, p<0.05). Moreover, CCB use was associated with less chance to be admitted to Intensive Care Unit (p: 0.029) for the whole hospital stay. Regarding the outcomes, CCB use seems to have no association with the development of acute renal failure and in-hospital mortality (p>0.05). However, it is associated with less respiratory failure needing high flow oxygen (p: 0.008), less bacteremia (p<0.037) as well as less chances of developing severe sepsis or septic shock (p: 0.001).
CONCLUSIONS: Pre-hospital CCB use is inversely associated with the development of respiratory failure, bacteremia and severe sepsis in patients with pneumonia.
CLINICAL IMPLICATIONS: Pneumonia is one of leading causes for hospital admission, sepsis and death. CCBs have been shown to be beneficial in animal sepsis syndrome models as an immunomodulator. As the first study to asses the beneficial effect(s) of CCBs in severe infections in human subjects, our study adds to the accumulating evidences from animal studies that CCB use is associated with better outcomes in severe infections like pneumonia.
DISCLOSURE: The following authors have nothing to disclose: Lin Zheng, Sameer Poddar
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