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Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study

BACKGROUND: There is still no agreement on whether corticosteroids can reduce mortality in patients with acute respiratory distress syndrome (ARDS). The aim of this study was to investigate the efficacy of low-dose corticosteroid administration in patients with ARDS. METHODS: A prospective observati...

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Autores principales: Zhang, Ruoyang, Huang, Xu, Lu, Haining, Fan, Guohui, Cai, Ying, Tian, Ye, Xia, Jingen, Deng, Wang, Wang, Daoxin, Li, Junlu, Wang, Shilei, Xing, Lihua, Liu, Shaohua, Sun, Tongwen, Wu, Dawei, Zhan, Qingyuan, Wang, Chen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344422/
https://www.ncbi.nlm.nih.gov/pubmed/35928619
http://dx.doi.org/10.21037/jtd-21-890
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author Zhang, Ruoyang
Huang, Xu
Lu, Haining
Fan, Guohui
Cai, Ying
Tian, Ye
Xia, Jingen
Deng, Wang
Wang, Daoxin
Li, Junlu
Wang, Shilei
Xing, Lihua
Liu, Shaohua
Sun, Tongwen
Wu, Dawei
Zhan, Qingyuan
Wang, Chen
author_facet Zhang, Ruoyang
Huang, Xu
Lu, Haining
Fan, Guohui
Cai, Ying
Tian, Ye
Xia, Jingen
Deng, Wang
Wang, Daoxin
Li, Junlu
Wang, Shilei
Xing, Lihua
Liu, Shaohua
Sun, Tongwen
Wu, Dawei
Zhan, Qingyuan
Wang, Chen
author_sort Zhang, Ruoyang
collection PubMed
description BACKGROUND: There is still no agreement on whether corticosteroids can reduce mortality in patients with acute respiratory distress syndrome (ARDS). The aim of this study was to investigate the efficacy of low-dose corticosteroid administration in patients with ARDS. METHODS: A prospective observational study of patients with ARDS in 17 hospitals in China was performed between March 2016 and February 2018. Propensity score matching was performed to adjust for differences in baseline characteristics between different groups. The effects of corticosteroids were assessed by using the Kaplan-Meier method and a multivariate Cox regression. RESULTS: A total of 527 ARDS patients were enrolled in the study. Sixty-five patients (12.3%) were administered low-dose (methylprednisolone ≤1 mg·kg(−1)·d(−1)) corticosteroids. The median dose was equivalent to 0.67 (0.57–0.81) mg/kg methylprednisolone for a median duration of 10 days. The control group included 224 patients (42.5%) who had never receive corticosteroids. In the matched sample, the hospital mortality rates in the low-dose (n=40) and control groups (n=80) were 27.5% and 42.5% (P=0.110), respectively. The length of hospital stay was significantly longer in the low-dose corticosteroid group than in the control group (24.0 vs. 17.0, P=0.002), and the multivariate Cox regression analysis suggested that the low-dose group had a significantly lower risk of death than the control group (HR: 0.48; 95% CI: 0.24–0.97; P=0.040). CONCLUSIONS: The administration of low-dose corticosteroids may reduce mortality in patients with ARDS.
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spelling pubmed-93444222022-08-03 Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study Zhang, Ruoyang Huang, Xu Lu, Haining Fan, Guohui Cai, Ying Tian, Ye Xia, Jingen Deng, Wang Wang, Daoxin Li, Junlu Wang, Shilei Xing, Lihua Liu, Shaohua Sun, Tongwen Wu, Dawei Zhan, Qingyuan Wang, Chen J Thorac Dis Original Article BACKGROUND: There is still no agreement on whether corticosteroids can reduce mortality in patients with acute respiratory distress syndrome (ARDS). The aim of this study was to investigate the efficacy of low-dose corticosteroid administration in patients with ARDS. METHODS: A prospective observational study of patients with ARDS in 17 hospitals in China was performed between March 2016 and February 2018. Propensity score matching was performed to adjust for differences in baseline characteristics between different groups. The effects of corticosteroids were assessed by using the Kaplan-Meier method and a multivariate Cox regression. RESULTS: A total of 527 ARDS patients were enrolled in the study. Sixty-five patients (12.3%) were administered low-dose (methylprednisolone ≤1 mg·kg(−1)·d(−1)) corticosteroids. The median dose was equivalent to 0.67 (0.57–0.81) mg/kg methylprednisolone for a median duration of 10 days. The control group included 224 patients (42.5%) who had never receive corticosteroids. In the matched sample, the hospital mortality rates in the low-dose (n=40) and control groups (n=80) were 27.5% and 42.5% (P=0.110), respectively. The length of hospital stay was significantly longer in the low-dose corticosteroid group than in the control group (24.0 vs. 17.0, P=0.002), and the multivariate Cox regression analysis suggested that the low-dose group had a significantly lower risk of death than the control group (HR: 0.48; 95% CI: 0.24–0.97; P=0.040). CONCLUSIONS: The administration of low-dose corticosteroids may reduce mortality in patients with ARDS. AME Publishing Company 2022-07 /pmc/articles/PMC9344422/ /pubmed/35928619 http://dx.doi.org/10.21037/jtd-21-890 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Zhang, Ruoyang
Huang, Xu
Lu, Haining
Fan, Guohui
Cai, Ying
Tian, Ye
Xia, Jingen
Deng, Wang
Wang, Daoxin
Li, Junlu
Wang, Shilei
Xing, Lihua
Liu, Shaohua
Sun, Tongwen
Wu, Dawei
Zhan, Qingyuan
Wang, Chen
Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study
title Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study
title_full Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study
title_fullStr Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study
title_full_unstemmed Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study
title_short Efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study
title_sort efficacy of low-dose corticosteroids in patients with acute respiratory distress syndrome: a prospective observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344422/
https://www.ncbi.nlm.nih.gov/pubmed/35928619
http://dx.doi.org/10.21037/jtd-21-890
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