TY - JOUR T1 - Low-dose corticosteroid use and mortality in severe community-acquired pneumonia patients JF - European Respiratory Journal JO - Eur Respir J SP - 463 LP - 472 DO - 10.1183/09031936.00081514 VL - 45 IS - 2 AU - Takashi Tagami AU - Hiroki Matsui AU - Hiromasa Horiguchi AU - Kiyohide Fushimi AU - Hideo Yasunaga Y1 - 2015/02/01 UR - http://erj.ersjournals.com/content/45/2/463.abstract N2 - The relationship between low-dose corticosteroid use and mortality in patients with severe community-acquired pneumonia (CAP) remains unclear.6925 patients with severe CAP who received mechanical ventilation with or without shock (defined as use of catecholamines) at 983 hospitals were identified using a Japanese nationwide administrative database. The main outcome measure was 28-day mortality.2524 patients with severe CAP who received catecholamines were divided into corticosteroid (n=631) and control (n=1893) groups. The 28-day mortality was significantly different between corticosteroid and control groups (unmatched: 24.6% versus 36.3%, p<0.001; propensity score-matched: 25.3% versus 32.6%, p=0.01; inverse probability-weighted: 27.5% versus 34.2%, p<0.001). 4401 patients with severe CAP who did not receive catecholamines were also divided into corticosteroid (n=1112) and control (n=3289) groups. The 28-day mortality was not significantly different between corticosteroid and control groups in propensity score-matched analyses (unmatched: 16.0% versus 19.4%, p=0.01; propensity score-matched: 17.7% versus 15.6%, p=0.22; inverse probability-weighted: 18.8% versus 18.2%, p=0.44).Low-dose corticosteroid use may be associated with reduced 28-day mortality in patients with septic shock complicating CAP.Low-dose corticosteroids in severe CAP patients was associated with better prognosis only in those with septic shock http://ow.ly/AWqZW ER -