Frontiers in Pharmacology · 8 authors, 3 centres
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This retrospective cohort study of 1,030 ICU patients with acute pancreatitis from the MIMIC-IV database found that ondansetron administration was associated with improved in-hospital, 90-day, and overall survival outcomes, with a recommended minimum total dose of 4–8 mg.
This retrospective cohort study analyzed 1,030 patients with acute pancreatitis admitted to the ICU between 2008 and 2019 using the MIMIC-IV database. Ondansetron was associated with improved outcomes across all three endpoints, with optimal minimum total doses identified at 7.8 mg for in-hospital, 4.9 mg for 90-day, and 4.6 mg for overall prognosis. The survival benefit was not dependent on the timing of medication initiation. In multivariate analysis comparing other antiemetics, ondansetron showed prominent and stable prognostic benefits relative to metoclopramide, diphenhydramine, and prochlorperazine. Limitations include the retrospective design, inability to determine cause of death, and difficulty obtaining side-effect data, which constrains the dosage recommendations. The authors suggest potential anti-inflammatory mechanisms via 5-HT3 receptor antagonism as contributing to the observed survival benefits.
