Liao WI, et al. - This article was written with the objective to figure out if the utilization of valproic acid (VPA) is related to a reduced risk of acute respiratory failure (ARF) in patients. Any utilization of VPA was related to a decreased risk of ARF in patients with subarachnoid hemorrhage (SAH). VPA may be beneficial for reducing the risk of pneumonia-induced ARF in patients with SAH.

Methods

• The Taiwan National Health Insurance Research Database was utilized to investigate all patients newly diagnosed with SAH from 2000 to 2010.
• The VPA users were matched for age, gender and index date in 1:2 ratios with randomly selected non-VPA users as a comparison group.
• Multivariate Cox regression was utilized to identify the predictors of ARF and to compare the incidence rates of ARF among SAH patients utilizing and not using VPA.

Results

• The study cohort included 16,228 newly diagnosed SAH patients, from which 521 VPA users and 1,042 matched non-VPA-exposed individuals were selected.
• In the VPA-treated cohort and the non-VPA-treated cohort, 117 and 289 patients developed ARF, respectively.
• Any utilization of VPA was related to a 16% reduced risk of ARF requiring mechanical ventilation in 30-day tracking of the SAH patients (adjusted hazard ratio [HR], 0.840, 95% confidence interval [CI], 0.676-0.945).
• Age, sepsis and pneumonia were identified as independent predictors of ARF in patients with SAH.
• After stratification, VPA users demonstrated a lower risk of ARF among SAH patients complicated with pneumonia compared with non-users of VPA (adjusted HR, 0.816, 95% CI, 0.652-0.921).