Risk of sepsis in patients with primary aldosteronism

Autor: Chieh-Kai Chan, Ya-Hui Hu, Likwang Chen, Chin-Chen Chang, Yu-Feng Lin, Tai-Shuan Lai, Kuo-How Huang, Yen-Hung Lin, Vin-Cent Wu, Kwan-Dun Wu, TAIPAI Study Group
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Critical Care, Vol 22, Iss 1, Pp 1-11 (2018)
Druh dokumentu: article
ISSN: 1364-8535
21426945
DOI: 10.1186/s13054-018-2239-y
Popis: Abstract Background The interaction between hyperaldosteronism and immune dysfunction has been reported and glucocorticoid co-secretion is frequently found in primary aldosteronism (PA). The aforementioned conditions raise the possibility of the infection risk; however, clinical episodes of sepsis have not been reported in PA. Methods Using Taiwan’s National Health Insurance Research Database between 1997 and 2009, we identified PA and aldosterone-producing adenoma (APA) matched with essential hypertension (EH) at a 1:1 ratio by propensity scores. The incidences of sepsis and mortality after the index date were evaluated, and the risk factors of outcomes were identified using adjusted Cox proportional hazards models and taking mortality as a competing risk. Results We enrolled 2448 patients with PA (male, 46.08%; mean age, 48.4 years). There were 875 patients who could be ascertained as APA. Taking mortality as the competing risk, APA patients had a lower incidence of sepsis than their matched EH patients (hazard ratio (HR) 0.29; P
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