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

13 páginas

Detalhes bibliográficos
Autores: Alejandro Rodríguez, Gerard Moreno, Reyes Velasco, Luis Felipe, Gomez, Josep, Sole Violan, Jordi, Díaz, Emili, Bodí, María, Trefler, Sandra, Guardiola, Juan, Yébenes, Juan C., Soriano, Alex, Garnacho Montero, José, Socias, Lorenzo, Valle Ortíz, María del, Correig, Eudald
Tipo de documento: artigo
Data de publicação:2018
País:Colombia
Recursos:Universidad de la Sabana
Repositório:Repositorio Universidad de la Sabana
Idioma:espanhol
OAI Identifier:oai:10.145.21.57:10818/36380
Acesso em linha:https://link.springer.com/article/10.1007%2Fs00134-018-5332-4#citeas
http://hdl.handle.net/10818/36380
https://doi.org/10.1007/s0013
Access Level:Acceso aberto
Palavra-chave:Influenza
Pneumonia
Corticosteroids
ICU
Mortality
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spelling Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching studyAlejandro Rodríguez, Gerard MorenoReyes Velasco, Luis FelipeGomez, JosepSole Violan, JordiDíaz, EmiliBodí, MaríaTrefler, SandraGuardiola, JuanYébenes, Juan C.Soriano, AlexGarnacho Montero, JoséSocias, LorenzoValle Ortíz, María delCorreig, EudaldInfluenzaPneumoniaCorticosteroidsICUMortality13 páginasPurpose To determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia. Methods Secondary 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. Results A 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%) than in patients who did not receive corticosteroids (18.8%, p < 0.001). After PS matching, corticosteroid use was associated with ICU mortality in the Cox (HR = 1.32 [95% CI 1.08–1.60], p < 0.006) and competing risks analysis (SHR = 1.37 [95% CI 1.12–1.68], p = 0.001). Conclusion Administration of corticosteroids in patients with severe influenza pneumonia is associated with increased ICU mortality, and these agents should not be used as co-adjuvant therapy.Intensive Care Medicine2019-07-26T13:51:38Z2019-07-26T13:51:38Z2018-09articlepublishedVersioninfo:eu-repo/semantics/articleapplication/pdfMoreno, G., Rodríguez, A., Reyes, L.F. et al. Intensive Care Med (2018) 44: 1470. https://doi.org/10.1007/s00134-018-5332-40342-4642https://link.springer.com/article/10.1007%2Fs00134-018-5332-4#citeashttp://hdl.handle.net/10818/36380https://doi.org/10.1007/s0013Universidad de La SabanaIntellectum Repositorio Universidad de La Sabanareponame:Repositorio Universidad de la Sabanainstname:Universidad de la Sabanainstacron:Universidad de la SabanaspaIntensive Care Med (2018) 44: 1470Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccess2019-10-09T20:08:41Z
dc.title.none.fl_str_mv Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
title Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
spellingShingle Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
Alejandro Rodríguez, Gerard Moreno
Influenza
Pneumonia
Corticosteroids
ICU
Mortality
title_short Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
title_full Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
title_fullStr Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
title_full_unstemmed Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
title_sort Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
dc.creator.none.fl_str_mv Alejandro Rodríguez, Gerard Moreno
Reyes Velasco, Luis Felipe
Gomez, Josep
Sole Violan, Jordi
Díaz, Emili
Bodí, María
Trefler, Sandra
Guardiola, Juan
Yébenes, Juan C.
Soriano, Alex
Garnacho Montero, José
Socias, Lorenzo
Valle Ortíz, María del
Correig, Eudald
author Alejandro Rodríguez, Gerard Moreno
author_facet Alejandro Rodríguez, Gerard Moreno
Reyes Velasco, Luis Felipe
Gomez, Josep
Sole Violan, Jordi
Díaz, Emili
Bodí, María
Trefler, Sandra
Guardiola, Juan
Yébenes, Juan C.
Soriano, Alex
Garnacho Montero, José
Socias, Lorenzo
Valle Ortíz, María del
Correig, Eudald
author_role author
author2 Reyes Velasco, Luis Felipe
Gomez, Josep
Sole Violan, Jordi
Díaz, Emili
Bodí, María
Trefler, Sandra
Guardiola, Juan
Yébenes, Juan C.
Soriano, Alex
Garnacho Montero, José
Socias, Lorenzo
Valle Ortíz, María del
Correig, Eudald
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Influenza
Pneumonia
Corticosteroids
ICU
Mortality
topic Influenza
Pneumonia
Corticosteroids
ICU
Mortality
description 13 páginas
publishDate 2018
dc.date.none.fl_str_mv 2018-09
2019-07-26T13:51:38Z
2019-07-26T13:51:38Z
dc.type.none.fl_str_mv article
publishedVersion
info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv Moreno, G., Rodríguez, A., Reyes, L.F. et al. Intensive Care Med (2018) 44: 1470. https://doi.org/10.1007/s00134-018-5332-4
0342-4642
https://link.springer.com/article/10.1007%2Fs00134-018-5332-4#citeas
http://hdl.handle.net/10818/36380
https://doi.org/10.1007/s0013
identifier_str_mv Moreno, G., Rodríguez, A., Reyes, L.F. et al. Intensive Care Med (2018) 44: 1470. https://doi.org/10.1007/s00134-018-5332-4
0342-4642
url https://link.springer.com/article/10.1007%2Fs00134-018-5332-4#citeas
http://hdl.handle.net/10818/36380
https://doi.org/10.1007/s0013
dc.language.none.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv Intensive Care Med (2018) 44: 1470
dc.rights.none.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Intensive Care Medicine
publisher.none.fl_str_mv Intensive Care Medicine
dc.source.none.fl_str_mv Universidad de La Sabana
Intellectum Repositorio Universidad de La Sabana
reponame:Repositorio Universidad de la Sabana
instname:Universidad de la Sabana
instacron:Universidad de la Sabana
instname_str Universidad de la Sabana
instacron_str Universidad de la Sabana
institution Universidad de la Sabana
reponame_str Repositorio Universidad de la Sabana
collection Repositorio Universidad de la Sabana
_version_ 1825050560870481920
score 15,638193

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