000151447 001__ 151447
000151447 005__ 20251017144611.0
000151447 0247_ $$2doi$$a10.1007/s00134-018-5332-4
000151447 0248_ $$2sideral$$a143126
000151447 037__ $$aART-2018-143126
000151447 041__ $$aeng
000151447 100__ $$aMoreno, Gerard
000151447 245__ $$aCorticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study
000151447 260__ $$c2018
000151447 5060_ $$aAccess copy available to the general public$$fUnrestricted
000151447 5203_ $$aPurpose
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.
000151447 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000151447 590__ $$a18.967$$b2018
000151447 591__ $$aCRITICAL CARE MEDICINE$$b2 / 33 = 0.061$$c2018$$dQ1$$eT1
000151447 592__ $$a3.654$$b2018
000151447 593__ $$aCritical Care and Intensive Care Medicine$$c2018$$dQ1
000151447 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000151447 700__ $$aRodríguez, Alejandro
000151447 700__ $$aReyes, Luis F.
000151447 700__ $$aGomez, Josep
000151447 700__ $$aSole-Violan, Jordi
000151447 700__ $$aDíaz, Emili
000151447 700__ $$aBodí, María
000151447 700__ $$aTrefler, Sandra
000151447 700__ $$aGuardiola, Juan
000151447 700__ $$aYébenes, Juan C.
000151447 700__ $$aSoriano, Alex
000151447 700__ $$aGarnacho-Montero, José
000151447 700__ $$aSocias, Lorenzo
000151447 700__ $$adel Valle Ortíz, María
000151447 700__ $$aCorreig, Eudald
000151447 700__ $$aMarín-Corral, Judith
000151447 700__ $$aVallverdú-Vidal, Montserrat
000151447 700__ $$aRestrepo, Marcos I.
000151447 700__ $$aTorres, Antoni
000151447 700__ $$aMartín-Loeches, Ignacio
000151447 700__ $$aCobo, Pedro
000151447 700__ $$aMartins, Javier
000151447 700__ $$aCarbayo, Cecilia
000151447 700__ $$aRobles-Musso, Emilio
000151447 700__ $$aCárdenas, Antonio
000151447 700__ $$aFierro, Javier
000151447 700__ $$aOcaña Fernández, Dolores
000151447 700__ $$aSierra, Rafael
000151447 700__ $$aHuertos, Mª Jesús
000151447 700__ $$aCarmona Pérez, Mª Luz
000151447 700__ $$aPozo Laderas, Juan Carlos
000151447 700__ $$aGuerrero, R.
000151447 700__ $$aRobles, Juan Carlos
000151447 700__ $$aEchevarría León, Melissa
000151447 700__ $$aBermejo Gómez, Alberto
000151447 700__ $$aMárquez, Enrique
000151447 700__ $$aRodríguez-Carvajal, Manuel
000151447 700__ $$aEstella, Ángel
000151447 700__ $$aPomares, José
000151447 700__ $$aBallesteros, José Luis
000151447 700__ $$aMoreno Romero, Olga
000151447 700__ $$aFernández, Yolanda
000151447 700__ $$aLobato, Francisco
000151447 700__ $$aPrieto, José F.
000151447 700__ $$aAlbofedo-Sánchez, José
000151447 700__ $$aMartínez, Pilar
000151447 700__ $$ade la Torre, María Victoria
000151447 700__ $$aNieto, María
000151447 700__ $$aCamara Sola, Estefanía
000151447 700__ $$aDíaz Castellanos, Miguel Angel
000151447 700__ $$aSevilla Soler, Guillermo
000151447 700__ $$aOrtiz Leyba, Carlos
000151447 700__ $$aHinojosa, Rafael
000151447 700__ $$aFernández, Esteban
000151447 700__ $$aLoza, Ana
000151447 700__ $$aLeón, Cristóbal
000151447 700__ $$aGonzález López, Samuel
000151447 700__ $$aArenzana, Angel
000151447 700__ $$aNavarrete, Inés
000151447 700__ $$aZaheri Beryanaki, Medhi
000151447 700__ $$aSánchez, Ignacio
000151447 700__ $$aPérez Alé, Manuel
000151447 700__ $$aPoullet Brea, Ana Mª
000151447 700__ $$aMachado Casas, Juan Francisco
000151447 700__ $$0(orcid)0000-0002-8068-5016$$aSerón, Carlos$$uUniversidad de Zaragoza
000151447 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000151447 773__ $$g44, 9 (2018), 1470-1482$$pIntensive care med.$$tINTENSIVE CARE MEDICINE$$x0342-4642
000151447 8564_ $$s430889$$uhttps://zaguan.unizar.es/record/151447/files/texto_completo.pdf$$yPostprint
000151447 8564_ $$s1705754$$uhttps://zaguan.unizar.es/record/151447/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000151447 909CO $$ooai:zaguan.unizar.es:151447$$particulos$$pdriver
000151447 951__ $$a2025-10-17-14:17:18
000151447 980__ $$aARTICLE