151447 20251017144611.0 doi 10.1007/s00134-018-5332-4 sideral 143126 ART-2018-143126 eng Moreno, Gerard Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study 2018 Access copy available to the general public Unrestricted Purpose 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. info:eu-repo/semantics/openAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 18.967 2018 CRITICAL CARE MEDICINE 2 / 33 = 0.061 2018 Q1 T1 3.654 2018 Critical Care and Intensive Care Medicine 2018 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Rodríguez, Alejandro Reyes, Luis F. Gomez, Josep Sole-Violan, Jordi Díaz, Emili Bodí, María Trefler, Sandra Guardiola, Juan Yébenes, Juan C. Soriano, Alex Garnacho-Montero, José Socias, Lorenzo del Valle Ortíz, María Correig, Eudald Marín-Corral, Judith Vallverdú-Vidal, Montserrat Restrepo, Marcos I. Torres, Antoni Martín-Loeches, Ignacio Cobo, Pedro Martins, Javier Carbayo, Cecilia Robles-Musso, Emilio Cárdenas, Antonio Fierro, Javier Ocaña Fernández, Dolores Sierra, Rafael Huertos, Mª Jesús Carmona Pérez, Mª Luz Pozo Laderas, Juan Carlos Guerrero, R. Robles, Juan Carlos Echevarría León, Melissa Bermejo Gómez, Alberto Márquez, Enrique Rodríguez-Carvajal, Manuel Estella, Ángel Pomares, José Ballesteros, José Luis Moreno Romero, Olga Fernández, Yolanda Lobato, Francisco Prieto, José F. Albofedo-Sánchez, José Martínez, Pilar de la Torre, María Victoria Nieto, María Camara Sola, Estefanía Díaz Castellanos, Miguel Angel Sevilla Soler, Guillermo Ortiz Leyba, Carlos Hinojosa, Rafael Fernández, Esteban Loza, Ana León, Cristóbal González López, Samuel Arenzana, Angel Navarrete, Inés Zaheri Beryanaki, Medhi Sánchez, Ignacio Pérez Alé, Manuel Poullet Brea, Ana Mª Machado Casas, Juan Francisco Serón, Carlos Universidad de Zaragoza (orcid)0000-0002-8068-5016 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 44, 9 (2018), 1470-1482 Intensive care med. INTENSIVE CARE MEDICINE 0342-4642 430889 http://zaguan.unizar.es/record/151447/files/texto_completo.pdf Postprint 1705754 http://zaguan.unizar.es/record/151447/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:151447 articulos driver 2025-10-17-14:17:18 ARTICLE