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Proton pump inhibitors use and clinical outcomes in critically ill patients with pulmonary fibrosis: A retrospective cohort study with propensity score matching.

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Τίτλος: Proton pump inhibitors use and clinical outcomes in critically ill patients with pulmonary fibrosis: A retrospective cohort study with propensity score matching.
Συγγραφείς: Ji W; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Wang G; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Wang Z; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Li T; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Ruan Y; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Hu T; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Shi Z; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Πηγή: Science progress [Sci Prog] 2026 Oct-Dec; Vol. 109 (4), pp. 368504261494961. Date of Electronic Publication: 2026 Oct 04.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: SAGE Publications Country of Publication: England NLM ID: 0411361 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-7163 (Electronic) Linking ISSN: 00368504 NLM ISO Abbreviation: Sci Prog Subsets: MEDLINE
Imprint Name(s): Publication: <2019-> : [London] : SAGE Publications
Original Publication: Oxford, Blackwell Scientific Publications [etc.]
Ιατρικοί όροι (MeSH): Proton Pump Inhibitors*/therapeutic use , Proton Pump Inhibitors*/adverse effects , Proton Pump Inhibitors*/administration & dosage , Critical Illness*/mortality , Pulmonary Fibrosis*/drug therapy , Pulmonary Fibrosis*/mortality, Humans ; Female ; Retrospective Studies ; Propensity Score ; Male ; Intensive Care Units ; Aged ; Middle Aged ; Treatment Outcome ; Length of Stay
Περίληψη: ObjectiveProton pump inhibitors (PPIs) are prescribed in the intensive care unit (ICU), but their association with outcomes in patients with pulmonary fibrosis remains unclear.MethodsWe conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (v3.1). Propensity score matching (PSM) and multivariate regression models adjusted for baseline differences. Landmark, subgroup, dose-response, and exploratory drug-specific analyses were performed.ResultsAmong 551 patients, 286 (51.9%) received PPIs. After PSM, PPI use was associated with higher 30-day mortality (HR 1.59, 95% CI 1.08-2.34; p = 0.019), 90-day mortality (HR 1.62, 95% CI 1.15-2.30; p = 0.006), ICU mortality (OR 3.22, 95% CI 1.57-6.59; p = 0.001), and longer ICU stay (β 1.90, 95% CI 0.91-2.88; p < 0.001). Associations weakened in the 48-hour landmark analysis, with only 90-day mortality remaining significant (adjusted HR 1.40, 95% CI 1.02-1.90; p = 0.035). Exploratory drug-specific estimates varied across agents but were imprecise. In exploratory cumulative-dose analyses after PSM and adjustment, each 10-mg increase in omeprazole-equivalent exposure was associated with higher ICU mortality (OR 1.06, 95% CI 1.01-1.10; p = 0.012) and longer ICU stay (β 0.34 days, 95% CI 0.28-0.40; p < 0.001), but not 30-day or 90-day mortality. Initial timing was not associated with mortality after PSM and adjustment but was associated with longer ICU stays. Subgroup associations were consistent, with an interaction between PPI and H2RA use for ICU length of stay.ConclusionsPPI exposure was associated with higher short-term mortality and longer ICU stay, although the associations weakened in the 48-hour landmark analysis, with only 90-day mortality remaining significant. Higher cumulative PPI doses were associated with higher ICU mortality and longer ICU stay. These findings are hypothesis-generating and require prospective confirmation before informing changes in clinical practice.
Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Contributed Indexing: Keywords: Proton pump inhibitors; intensive care unit; mortality; propensity score matching; pulmonary fibrosis
Substance Nomenclature: 0 (Proton Pump Inhibitors)
Entry Date(s): Date Created: 20261005 Date Completed: 20261005 Latest Revision: 20261005
Update Code: 20261005
DOI: 10.1177/00368504261494961
PMID: 42830476
Βάση Δεδομένων: MEDLINE
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  Data: Proton pump inhibitors use and clinical outcomes in critically ill patients with pulmonary fibrosis: A retrospective cohort study with propensity score matching.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ji+W%22&quot;&gt;Ji W&lt;/searchLink&gt;; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi&#39;an Jiaotong University, Xi&#39;an, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+G%22&quot;&gt;Wang G&lt;/searchLink&gt;; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi&#39;an Jiaotong University, Xi&#39;an, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+Z%22&quot;&gt;Wang Z&lt;/searchLink&gt;; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi&#39;an Jiaotong University, Xi&#39;an, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Li+T%22&quot;&gt;Li T&lt;/searchLink&gt;; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi&#39;an Jiaotong University, Xi&#39;an, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ruan+Y%22&quot;&gt;Ruan Y&lt;/searchLink&gt;; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi&#39;an Jiaotong University, Xi&#39;an, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Hu+T%22&quot;&gt;Hu T&lt;/searchLink&gt;; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi&#39;an Jiaotong University, Xi&#39;an, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Shi+Z%22&quot;&gt;Shi Z&lt;/searchLink&gt;; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi&#39;an Jiaotong University, Xi&#39;an, China.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: ObjectiveProton pump inhibitors (PPIs) are prescribed in the intensive care unit (ICU), but their association with outcomes in patients with pulmonary fibrosis remains unclear.MethodsWe conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (v3.1). Propensity score matching (PSM) and multivariate regression models adjusted for baseline differences. Landmark, subgroup, dose-response, and exploratory drug-specific analyses were performed.ResultsAmong 551 patients, 286 (51.9%) received PPIs. After PSM, PPI use was associated with higher 30-day mortality (HR 1.59, 95% CI 1.08-2.34; p = 0.019), 90-day mortality (HR 1.62, 95% CI 1.15-2.30; p = 0.006), ICU mortality (OR 3.22, 95% CI 1.57-6.59; p = 0.001), and longer ICU stay (β 1.90, 95% CI 0.91-2.88; p &amp;lt; 0.001). Associations weakened in the 48-hour landmark analysis, with only 90-day mortality remaining significant (adjusted HR 1.40, 95% CI 1.02-1.90; p = 0.035). Exploratory drug-specific estimates varied across agents but were imprecise. In exploratory cumulative-dose analyses after PSM and adjustment, each 10-mg increase in omeprazole-equivalent exposure was associated with higher ICU mortality (OR 1.06, 95% CI 1.01-1.10; p = 0.012) and longer ICU stay (β 0.34 days, 95% CI 0.28-0.40; p &amp;lt; 0.001), but not 30-day or 90-day mortality. Initial timing was not associated with mortality after PSM and adjustment but was associated with longer ICU stays. Subgroup associations were consistent, with an interaction between PPI and H2RA use for ICU length of stay.ConclusionsPPI exposure was associated with higher short-term mortality and longer ICU stay, although the associations weakened in the 48-hour landmark analysis, with only 90-day mortality remaining significant. Higher cumulative PPI doses were associated with higher ICU mortality and longer ICU stay. These findings are hypothesis-generating and require prospective confirmation before informing changes in clinical practice.
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  Data: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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        Value: 10.1177/00368504261494961
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        Text: English
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        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Retrospective Studies
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      – SubjectFull: Intensive Care Units
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      – SubjectFull: Pulmonary Fibrosis drug therapy
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      – SubjectFull: Pulmonary Fibrosis mortality
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    Titles:
      – TitleFull: Proton pump inhibitors use and clinical outcomes in critically ill patients with pulmonary fibrosis: A retrospective cohort study with propensity score matching.
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              Text: 2026 Oct-Dec
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