title: Analysis of systemic corticosteroid usage and survival in patients requiring mechanical ventilation for severe community-acquired pneumonia.
abstract: We evaluated the clinical data in patients who required mechanical ventilation for severe community-acquired pneumonia (CAP) and compared survival with and without the use of systemic corticosteroids. This retrospective study examined 97 patients with severe CAP in the MICU of the Asan Medical Center in Korea between January 2002 and November 2006. We collected data from medical charts about clinical and laboratory data, as well as 28-day and 3-month survival rates. Clinical baseline characteristics and scores on the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment were similar in the corticosteroid and noncorticosteroid groups. The 28-day and 3-month survival rates were 59.8% and 47.4% in all patients (56.7% and 45% in corticosteroid group and 64.9% and 54.3% in noncorticosteroid group, P > 0.05, respectively). Multivariate logistic regression analysis revealed that female sex [odds ratio (OR) 24.052], younger age (OR, 0.714), absence of acute respiratory distress syndrome (ARDS) (OR, 1.019e(4)), and absence of neoplasm (OR, 0.002) were associated with increased survival at 3 months. However, systemic corticosteroid was not associated with improving 28-day and 3-month survival rates.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Chungju Hospital, College of Medicine, Konkuk University, Chungju, Chungcheongbuk-do, 380-704, Republic of Korea.
authors.forename: Gyu Rak
authors.initials: GR
authors.lastname: Chon
authors.forename: Chae-Man
authors.initials: CM
authors.lastname: Lim
authors.forename: Younsuck
authors.initials: Y
authors.lastname: Koh
authors.forename: Sang-Bum
authors.initials: SB
authors.lastname: Hong
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D000704:Analysis of Variance; D003131:Combined Modality Therapy; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D009638:Norepinephrine