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Effect of corticosteroid therapy in the early phase of acute respiratory distress syndrome: a propensity-matched cohort study

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Abstract
Background/Aims: It is unclear whether corticosteroid use in patients with acute respiratory distress syndrome (ARDS) improves survival. This study aimed to investigate whether the administration of corticosteroids to patients in the early phase of moderate to severe ARDS is associated with improved outcomes.

Methods: We analyzed the data of patients who received corticosteroids within 7 days of the onset of ARDS between June 2006 and December 2015 at a single tertiary teaching hospital. A total of 565 patients admitted with moderate to severe ARDS were eligible. The outcomes of patients treated with methylprednisolone 40 to 180 mg/day or equivalent (n = 404) were compared to those who did not receive steroids (n = 161). The primary and secondary outcomes were 28- and 90-day mortality rates, respectively. Propensity scores were used to adjust for baseline covariates.

Results: The overall mortality at 28 days was not significantly different between the corticosteroid-treated and control groups (43.8% vs. 41%, p = 0.541). At 90 days, the overall mortality rate was higher in the corticosteroid-treated group than in the control group (59.2% vs. 48.4%, p = 0.021). However, on propensity score matching, corticosteroid therapy was not associated with a higher 28- day mortality rate (odds ratio, 1.031; 95% confidence interval, 0.657 to 1.618; p = 0.895) and 90 days (odds ratio, 1.435; 95% confidence interval, 0.877 to 2.348; p = 0.151).

Conclusions: Corticosteroid therapy was not associated with 28- or 90-day mortality in the early phase of moderate to severe ARDS on propensity score matching analysis.
Author(s)
고윤석백문성이윤경임채만허진원홍상범
Issued Date
2021
Type
Article
Keyword
adultCorticosteroidMortalityRespiratory distress syndrome
DOI
10.3904/kjim.2019.153
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7000
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_kiss_primary_3845887&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Effect%20of%20corticosteroid%20therapy%20in%20the%20early%20phase%20of%20acute%20respiratory%20distress%20syndrome:%20a%20propensity-matched%20cohort%20study&offset=0
Publisher
KOREAN JOURNAL OF INTERNAL MEDICINE
Location
대한민국
Language
영어
ISSN
1226-3303
Citation Volume
36
Citation Number
1
Citation Start Page
145
Citation End Page
145
Appears in Collections:
Medicine > Medicine
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