학술논문

Risk of sepsis in patients with primary aldosteronism
Document Type
article
Source
Critical Care, Vol 22, Iss 1, Pp 1-11 (2018)
Subject
Primary aldosteronism
Hypertension
Sepsis
Oxidative stress
Chronic inflammation
Glucocorticoid
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
Language
English
ISSN
1364-8535
21426945
Abstract
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