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Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Septicemia | Research

Early administration of multiple vasopressors is associated with better survival in patients with sepsis: a propensity score-weighted study

Authors: Xin Tong, Xiaopeng Xue, Chuanzhi Duan, Aihua Liu

Published in: European Journal of Medical Research | Issue 1/2023

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Abstract

Background

The association between the timing of administration of multiple vasopressors and patient outcomes has not been investigated.

Methods

This study used data from the MIMIC-IV database. Patients with sepsis who were administered two or more vasopressors were included. The principal exposure was the last norepinephrine dose when adding a second vasopressor. The cohort was divided into early (last norepinephrine dose < 0.25 μg/kg/min) and normal (last norepinephrine dose ≥ 0.25 μg/kg/min) groups. The primary outcome was 28-day mortality. Multivariable Cox analyses, propensity score matching, stabilized inverse probability of treatment weighting (sIPTW), and restricted cubic spline (RCS) curves were used.

Results

Overall, 1,437 patients who received multiple vasopressors were included. Patients in the early group had lower 28-day mortality (HR: 0.76; 95% CI: 0.65–0.89; p < 0.001) than those in the single group, with similar results in the propensity score-matched (HR: 0.80; 95% CI: 0.68–0.94; p = 0.006) and sIPTW (HR: 0.75; 95% CI: 0.63–0.88; p < 0.001) cohorts. RCS curves showed that the risk of 28-day mortality increased as the last norepinephrine dose increased.

Conclusions

The timing of secondary vasopressor administration is strongly associated with the outcomes of patients with sepsis.
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Metadata
Title
Early administration of multiple vasopressors is associated with better survival in patients with sepsis: a propensity score-weighted study
Authors
Xin Tong
Xiaopeng Xue
Chuanzhi Duan
Aihua Liu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-01229-w

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