Association between Nafamostat Mesylate and In-Hospital Mortality in Patients with Coronavirus Disease 2019: A Multicenter Observational Study

DOI record: { "DOI": "10.3390/jcm11010116", "ISSN": [ "2077-0383" ], "URL": "http://dx.doi.org/10.3390/jcm11010116", "abstract": "<jats:p>Nafamostat mesylate may be effective against coronavirus disease 2019 (COVID-19). However, it is not known whether its use is associated with reduced in-hospital mortality in clinical practice. We conducted a retrospective observational study to evaluate the effect of nafamostat mesylate in patients with COVID-19 using the Medical Data Vision Co. Ltd. hospital-based database in Japan. We compared patients with COVID-19 who were (n = 121) and were not (n = 15,738) administered nafamostat mesylate within 2 days of admission between January and December 2020. We conducted a 1:4 propensity score matching with multiple imputations for smoking status and body mass index and combined the 20 imputed propensity score-matched datasets to obtain the adjusted odds ratio for in-hospital mortality. Crude in-hospital mortality was 13.2% (16/121) and 5.0% (790/15,738), respectively. In the propensity score-matched analysis with multiple imputations, the adjusted odds ratio (use vs. no use of nafamostat mesylate) for in-hospital mortality was 1.27 (95% confidence interval: 0.61–2.64; p = 0.52). Sensitivity analyses showed similar results. The results of this retrospective observational study did not support an association between nafamostat mesylate and improved in-hospital outcomes in patients with COVID-19, although further studies with larger sample sizes are warranted to assess the generalizability of our findings.</jats:p>", "alternative-id": [ "jcm11010116" ], "author": [ { "ORCID": "https://orcid.org/0000-0001-6343-2298", "affiliation": [ { "name": "Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "authenticated-orcid": false, "family": "Inokuchi", "given": "Ryota", "sequence": "first" }, { "affiliation": [ { "name": "Montefiore Medical Center, Division of Cardiology, Albert Einstein College of Medicine, New York, NY 10461, USA" } ], "family": "Kuno", "given": "Toshiki", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan" }, { "name": "Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "family": "Komiyama", "given": "Jun", "sequence": "additional" }, { "affiliation": [ { "name": "Health Services Research and Development Center, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "family": "Uda", "given": "Kazuaki", "sequence": "additional" }, { "affiliation": [ { "name": "National Cancer Center, Institute for Cancer Control, Tokyo 104-0045, Japan" } ], "family": "Miyamoto", "given": "Yoshihisa", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0002-0176-2379", "affiliation": [ { "name": "Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan" }, { "name": "Health Services Research and Development Center, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "authenticated-orcid": false, "family": "Taniguchi", "given": "Yuta", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan" }, { "name": "Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba 305-8575, Japan" } ], "family": "Abe", "given": "Toshikazu", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "family": "Ishimaru", "given": "Miho", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0003-4277-4509", "affiliation": [ { "name": "Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan" }, { "name": "Health Services Research and Development Center, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "authenticated-orcid": false, "family": "Adomi", "given": "Motohiko", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan" }, { "name": "Health Services Research and Development Center, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "family": "Tamiya", "given": "Nanako", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan" }, { "name": "Health Services Research and Development Center, University of Tsukuba, Tsukuba 305-8575, Japan" } ], "family": "Iwagami", "given": "Masao", "sequence": "additional" } ], "container-title": "Journal of Clinical Medicine", "container-title-short": "JCM", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2021, 12, 27 ] ], "date-time": "2021-12-27T06:00:54Z", "timestamp": 1640584854000 }, "deposited": { "date-parts": [ [ 2024, 7, 23 ] ], "date-time": "2024-07-23T19:01:26Z", "timestamp": 1721761286000 }, "indexed": { "date-parts": [ [ 2025, 2, 21 ] ], "date-time": "2025-02-21T19:29:40Z", 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