Association of pre-hospital theophylline use and mortality in chronic obstructive pulmonary disease patients with sepsis.

Abstract:

BACKGROUND:Although theophylline has been shown to have anti-inflammatory effects, the therapeutic use of theophylline before sepsis is unknown. The aim of our study was to determine the effect of theophylline on COPD patients presenting with sepsis. METHODS:This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan's National Health Insurance program. Patients with COPD who were hospitalized for sepsis between 2000 and 2011 were divided into theophylline users and non-users. The primary outcome was 30-day mortality. The secondary outcome was in-hospital death, intensive care unit admission, and need for mechanical ventilation. Cox proportional hazard model and conditional logistic regression were used to calculate the risk between groups. RESULTS:A propensity score-matched cohort of 51,801 theophylline users and 51,801 non-users was included. Compared with non-users, the 30-day (HR 0.931, 95% CI 0.910-0.953), 180-day (HR 0.930, 95% CI 0.914-0.946), 365-day (HR 0.944, 95% CI 0.929-0.960) and overall mortality (HR 0.965, 95% CI 0.952-0.979) were all significantly lower in theophylline users. Additionally, the theophylline users also had lower risk of in-hospital death (OR 0.895, 95% CI 0.873-0.918) and need for mechanical ventilation (OR 0.972, 95% CI 0.949-0.997). CONCLUSIONS:Theophylline use is associated with a lower risk of sepsis-related mortality in COPD patients. Pre-hospital theophylline use may be protective to COPD patients with sepsis.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Shih YN,Chen YT,Chu H,Shih CJ,Ou SM,Hsu YT,Chen RC,Quraishi SA,Aisiku IP,Seethala RR,Frendl G,Hou PC

doi

10.1016/j.rmed.2017.02.020

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

33-38

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(17)30042-2

journal_volume

125

pub_type

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