Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study

AbstractPurposeTo determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia.MethodsSecondary analysis of a prospective cohort study of critically ill patients with confirmed influenza pneumonia admitted to 148 ICUs in Spain between June 2009 and April 2014. Patients who received corticosteroid treatment for causes other than viral pneumonia (e.g., refractory septic shock and asthma or chronic obstructive pulmonary disease [COPD] exacerbation) were excluded. Patients with corticosteroid therapy were compared with those without corticosteroid therapy. We use a propensity score (PS) matching analysis to reduce confounding factors. The primary outcome was ICU mortality. Cox proportional hazards and competing risks analysis was performed to assess the impact of corticosteroids on ICU mortality.ResultsA total of 1846 patients with primary influenza pneumonia were enrolled. Corticosteroids were administered in 604 (32.7%) patients, with methylprednisolone the most frequently used corticosteroid (578/604 [95.7%]). The median daily dose was equivalent to 80  mg of methylprednisolone (IQR 60–120) for a median duration of 7 days (IQR 5–10). Asthma, COPD, hematological disease, and the need for mechanical ventilation were independently associated with corticosteroid use. Crude ICU mortality was higher in patients who received corticosteroids (27.5%)...
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research

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Source: The Lancet - Category: General Medicine Source Type: research
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Source: the Mail online | Health - Category: Consumer Health News Source Type: news
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Source: European Journal of Integrative Medicine - Category: Complementary Medicine Source Type: research
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Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research
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More News: Asthma | Chronic Obstructive Pulmonary | Corticosteroid Therapy | Hematology | Influenza | Intensive Care | Methylprednisolone | Pneumonia | Septic Shock | Spain Health | Study