Abstract
Community-acquired pneumonia (CAP) is a leading cause of mortality and morbidity worldwide despite correct antibiotic use. In CAP, corticosteroids have long been evaluated yielding heterogeneous results with regards to survival and, hence, its use has not yet been established.
We analyzed two prospective observational cohorts of patients with CAP admitted to ICU and high inflammatory response from Spain and Italy. A propensity score matching was used to obtain the balance among baseline variables in both groups. Patients with viral pneumonia or those who received hydrocortisone were excluded. Corticosteroid treatment was considered whether the patient received at least 72 hs of prednisone 30 mg/day or its equivalent.
Of 610 patients recruited, 198(32%) patients received corticosteroids. One-hundred and seventeen patients were matched by propensity score in each group. Patients who received corticosteroids developed less ARDS (14 (30%) vs 3(6.5)). We did not find differences in 28-day mortality between groups (21 [18%] vs 20 [17]). However, when we analysed and matched only patients who required invasive mechanical ventilation and/or presented septic shock, a significant difference was observed (28 [32%] vs 16 [18%] p=0.039 OR 0.47 95%CI 0.23-0.96) Fig 1.
Fig 1 Kaplan-meier survival curves.
Conclusion: Patients who required IVM and/or presented septic shock and received corticosteroids showed lower mortality.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA2856.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021