RT Journal Article
T1 Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study.
A1 Moreno, Gerard
A1 Rodriguez, Alejandro
A1 Reyes, Luis F
A1 Gomez, Josep
A1 Sole-Violan, Jordi
A1 Diaz, Emili
A1 Bodi, Maria
A1 Trefler, Sandra
A1 Guardiola, Juan
A1 Yebenes, Juan C
A1 Soriano, Alex
A1 Garnacho-Montero, Jose
A1 Socias, Lorenzo
A1 Del Valle Ortiz, Maria
A1 Correig, Eudald
A1 Marin-Corral, Judith
A1 Vallverdu-Vidal, Montserrat
A1 Restrepo, Marcos I
A1 Torres, Antoni
A1 Martin-Loeches, Ignacio
K1 Corticosteroids
K1 ICU
K1 Influenza
K1 Mortality
K1 Pneumonia
AB To determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia. 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. 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  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.
PB Springer
YR 2018
FD 2018-08-03
LK http://hdl.handle.net/10668/12800
UL http://hdl.handle.net/10668/12800
LA en
NO Moreno G, Rodríguez A, Reyes LF, Gomez J, Sole-Violan J, Díaz E, et al. Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study. Intensive Care Med. 2018 Sep;44(9):1470-1482.
DS RISalud
RD Apr 9, 2025