Cargando…
Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study
The effectiveness of systemic steroid therapy on mortality in patients with pneumonic chronic obstructive pulmonary disease (COPD) exacerbation is unclear. We evaluated the association between systemic steroid therapy and 30-day mortality after adjusting for known confounders, using data from the He...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10529550/ https://www.ncbi.nlm.nih.gov/pubmed/37756275 http://dx.doi.org/10.1371/journal.pone.0290647 |
_version_ | 1785111401754263552 |
---|---|
author | Shiroshita, Akihiro Anan, Keisuke Takeshita, Masafumi Kataoka, Yuki |
author_facet | Shiroshita, Akihiro Anan, Keisuke Takeshita, Masafumi Kataoka, Yuki |
author_sort | Shiroshita, Akihiro |
collection | PubMed |
description | The effectiveness of systemic steroid therapy on mortality in patients with pneumonic chronic obstructive pulmonary disease (COPD) exacerbation is unclear. We evaluated the association between systemic steroid therapy and 30-day mortality after adjusting for known confounders, using data from the Health, Clinic, and Education Information Evaluation Institute in Japan, which longitudinally followed up patients in the same hospital. We selected patients aged ≥40 years admitted for pneumonic COPD exacerbation. The exclusion criteria were censoring within 24 h, comorbidity with other respiratory diseases, and daily steroid use. Systemic steroid therapy was defined as oral/parenteral steroid therapy initiated within two days of admission. The primary outcome was the 30-day mortality rate. To account for known confounders, each patient was assigned an inverse probability of treatment weighting. The outcome was evaluated using logistic regression. Among 3,662 patients showing pneumonic COPD exacerbation, 30-day mortality in the steroid therapy and non-steroid therapy groups was 27.6% (169/612) and 21.9% (668/3,050), respectively. Systemic steroid therapy indicated a slightly higher estimated probability of 30-day mortality (difference in the estimated probabilities, 2.65%; 95% confidence interval, -1.23 to 6.54%, p-value = 0.181). Systemic steroid therapy within two days of admission was associated with higher 30-day mortality rates in pneumonic COPD exacerbation. Further validation studies based on chart reviews will be needed to cope with residual confounders. |
format | Online Article Text |
id | pubmed-10529550 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-105295502023-09-28 Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study Shiroshita, Akihiro Anan, Keisuke Takeshita, Masafumi Kataoka, Yuki PLoS One Research Article The effectiveness of systemic steroid therapy on mortality in patients with pneumonic chronic obstructive pulmonary disease (COPD) exacerbation is unclear. We evaluated the association between systemic steroid therapy and 30-day mortality after adjusting for known confounders, using data from the Health, Clinic, and Education Information Evaluation Institute in Japan, which longitudinally followed up patients in the same hospital. We selected patients aged ≥40 years admitted for pneumonic COPD exacerbation. The exclusion criteria were censoring within 24 h, comorbidity with other respiratory diseases, and daily steroid use. Systemic steroid therapy was defined as oral/parenteral steroid therapy initiated within two days of admission. The primary outcome was the 30-day mortality rate. To account for known confounders, each patient was assigned an inverse probability of treatment weighting. The outcome was evaluated using logistic regression. Among 3,662 patients showing pneumonic COPD exacerbation, 30-day mortality in the steroid therapy and non-steroid therapy groups was 27.6% (169/612) and 21.9% (668/3,050), respectively. Systemic steroid therapy indicated a slightly higher estimated probability of 30-day mortality (difference in the estimated probabilities, 2.65%; 95% confidence interval, -1.23 to 6.54%, p-value = 0.181). Systemic steroid therapy within two days of admission was associated with higher 30-day mortality rates in pneumonic COPD exacerbation. Further validation studies based on chart reviews will be needed to cope with residual confounders. Public Library of Science 2023-09-27 /pmc/articles/PMC10529550/ /pubmed/37756275 http://dx.doi.org/10.1371/journal.pone.0290647 Text en © 2023 Shiroshita et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Shiroshita, Akihiro Anan, Keisuke Takeshita, Masafumi Kataoka, Yuki Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study |
title | Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study |
title_full | Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study |
title_fullStr | Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study |
title_full_unstemmed | Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study |
title_short | Systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: A retrospective cohort study |
title_sort | systemic steroid therapy for pneumonic chronic obstructive pulmonary disease exacerbation: a retrospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10529550/ https://www.ncbi.nlm.nih.gov/pubmed/37756275 http://dx.doi.org/10.1371/journal.pone.0290647 |
work_keys_str_mv | AT shiroshitaakihiro systemicsteroidtherapyforpneumonicchronicobstructivepulmonarydiseaseexacerbationaretrospectivecohortstudy AT anankeisuke systemicsteroidtherapyforpneumonicchronicobstructivepulmonarydiseaseexacerbationaretrospectivecohortstudy AT takeshitamasafumi systemicsteroidtherapyforpneumonicchronicobstructivepulmonarydiseaseexacerbationaretrospectivecohortstudy AT kataokayuki systemicsteroidtherapyforpneumonicchronicobstructivepulmonarydiseaseexacerbationaretrospectivecohortstudy |