アサカワ タケシ   Asakawa Takeshi
  浅川 剛
   所属   関連施設  情報管理センター 情報管理センター
   職種   准教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome.
掲載誌名 正式名:Respirology (Carlton, Vic.)
略  称:Respirology
ISSNコード:14401843/13237799
巻・号・頁 22(4),708-713頁
著者・共著者 Kido Takashi, Muramatsu Keiji, Yatera Kazuhiro, Asakawa Takeshi, Otsubo Hiroki, Kubo Tatsuhiko, Fujino Yoshihisa, Matsuda Shinya, Mayumi Toshihiko, Mukae Hiroshi
発行年月 2017/05
概要 BACKGROUND AND OBJECTIVE:The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivelestat group and the non-sivelestat group within 7 days of admission.METHODS:This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non-sivelestat group.RESULTS:A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non-sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75-0.93; P < 0.002). Multiple regression analysis revealed that younger age, absence of cancer, no need for haemodialysis and no use of high-dose methylprednisolone were significantly correlated with treatment success (survive).CONCLUSION:These results of this retrospective and observational study suggest that administration of sivelestat within 7 days of admission may improve the prognosis of patients with ALI/ARDS. To our knowledge, this is the largest study to evaluate the efficacy of sivelestat on ALI/ARDS.
DOI 10.1111/resp.12969
PMID 27990710