DataSheet1_Ondansetron: recommended antiemetics for patients with acute pancreatitis? a population-based study.docx

Objective: Ondansetron administration is a common antemetic of acute pancreatitis therapy in the intensive care unit (ICU), but its actual association with patients’ outcomes has not been confirmed. The study is aimed to determine whether the multiple outcomes of ICU patients with acute pancreatitis could benefit from ondansetron.Methods: 1,030 acute pancreatitis patients diagnosed in 2008–2019 were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database as our study cohort. The primary outcome we considered is the 90-day prognosis, and secondary outcomes included in-hospital survival and overall prognosis.Results: In MIMIC-IV, 663 acute pancreatitis patients received ondansetron administration (OND group) during their hospitalization, while 367 patients did not (non-OND group). Patients in the OND group presented better in-hospital, 90-day, and overall survival curves than the non-OND group (log-rank test: in-hospital: p < 0.001, 90-day: p = 0.002, overall: p = 0.009). After including covariates, ondansetron was associated with better survival in patients with multiple outcomes (in-hospital: HR = 0.50, 90-day: HR = 0.63, overall: HR = 0.66), and the optimal dose inflection points were 7.8 mg, 4.9 mg, and 4.6 mg, respectively. The survival benefit of ondansetron was unique and stable in the multivariate analyses after consideration of metoclopramide, diphenhydramine, and prochlorperazine, which may also be used as antiemetics.Conclusion: In ICU acute pancreatitis patients, ondansetron administration was associated with better 90-day outcomes, while results were similar in terms of in-hospital and overall outcomes, and the recommended minimum total dose might be suggested to be 4–8 mg.

研究目的：奥丹司琼在重症监护病房（ICU）急性胰腺炎治疗中作为一种常见的止吐药物，但其与患者预后之间的实际关联尚未得到证实。本研究旨在探究ICU急性胰腺炎患者的多种预后是否能够从奥丹司琼的应用中获益。研究方法：从2008至2019年间诊断的、共计1,030例急性胰腺炎患者中，我们从重症监护医学信息市场（MIMIC）-IV数据库中提取了我们的研究队列。我们所考虑的主要预后指标为90天预后，次要预后指标包括住院存活率和总体预后。研究结果：在MIMIC-IV数据库中，663例急性胰腺炎患者在住院期间接受了奥丹司琼治疗（OND组），而367名患者未接受（非OND组）。OND组患者的住院、90天和总体存活曲线均优于非OND组（log-rank检验：住院：p < 0.001，90天：p = 0.002，总体：p = 0.009）。在纳入协变量后，奥丹司琼与具有多种预后的患者生存率的提高相关（住院：HR = 0.50，90天：HR = 0.63，总体：HR = 0.66），其最佳剂量拐点分别为7.8 mg、4.9 mg和4.6 mg。在考虑了甲氧氯普胺、苯海拉明和奋乃静等可能作为止吐药物使用的药物后，奥丹司琼的生存益处在多因素分析中显示出独特性和稳定性。结论：在ICU急性胰腺炎患者中，奥丹司琼的应用与更好的90天预后相关，而在住院和总体预后方面，结果相似，建议的最小总剂量可能为4–8 mg。