The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study
Identifieur interne : 005006 ( Main/Curation ); précédent : 005005; suivant : 005007The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study
Auteurs : Tung Wai Auyeung [République populaire de Chine] ; Jenny S. W. Lee [République populaire de Chine] ; Wing Kin Lai [République populaire de Chine] ; Chun Hung Choi [République populaire de Chine] ; Hoi Kan Lee [République populaire de Chine] ; Joo Shim Lee [République populaire de Chine] ; Po Chun Li [République populaire de Chine] ; Ka Ho Lok [République populaire de Chine] ; Yuk Yung Ng [République populaire de Chine] ; Wai Ming Wong [République populaire de Chine] ; Yiu Ming Yeung [République populaire de Chine]Source :
- The Journal of Infection [ 0163-4453 ] ; 2004.
Abstract
To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS).
A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, comorbidities, peak lactate dehydrogenase (LDH) levels and clinical outcomes. Established adverse prognostic factors including old age, comorbidities and high LDH levels were used as covariates in multiple logistic regressions to adjust for their confounding effect on adverse outcomes.
Among 78 patients, 66 patients (84.6%) received corticosteroid. The LDH level was similar in both groups. The corticosteroid group had more adverse outcomes (37.9% vs. 16.7%) despite younger age and less comorbidity. In multivariate analysis, corticosteroid treatment was associated with a 20.7-fold increase in risk of either ICU admission or mortality, independent of age and disease severity.
Despite more favourable baseline characteristics and similar peak LDH levels, SARS patients given corticosteroid had more adverse outcomes.
Url:
DOI: 10.1016/j.jinf.2004.09.008
PubMed: 16038758
PubMed Central: 7132384
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PMC:7132384Le document en format XML
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<author><name sortKey="Lai, Wing Kin" sort="Lai, Wing Kin" uniqKey="Lai W" first="Wing Kin" last="Lai">Wing Kin Lai</name>
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<author><name sortKey="Choi, Chun Hung" sort="Choi, Chun Hung" uniqKey="Choi C" first="Chun Hung" last="Choi">Chun Hung Choi</name>
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<author><name sortKey="Li, Po Chun" sort="Li, Po Chun" uniqKey="Li P" first="Po Chun" last="Li">Po Chun Li</name>
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<author><name sortKey="Lok, Ka Ho" sort="Lok, Ka Ho" uniqKey="Lok K" first="Ka Ho" last="Lok">Ka Ho Lok</name>
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<author><name sortKey="Ng, Yuk Yung" sort="Ng, Yuk Yung" uniqKey="Ng Y" first="Yuk Yung" last="Ng">Yuk Yung Ng</name>
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<author><name sortKey="Wong, Wai Ming" sort="Wong, Wai Ming" uniqKey="Wong W" first="Wai Ming" last="Wong">Wai Ming Wong</name>
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<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea>
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<author><name sortKey="Yeung, Yiu Ming" sort="Yeung, Yiu Ming" uniqKey="Yeung Y" first="Yiu Ming" last="Yeung">Yiu Ming Yeung</name>
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<country xml:lang="fr">République populaire de Chine</country>
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<series><title level="j">The Journal of Infection</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS).</p>
</sec>
<sec><title>Methods</title>
<p>A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, comorbidities, peak lactate dehydrogenase (LDH) levels and clinical outcomes. Established adverse prognostic factors including old age, comorbidities and high LDH levels were used as covariates in multiple logistic regressions to adjust for their confounding effect on adverse outcomes.</p>
</sec>
<sec><title>Results</title>
<p>Among 78 patients, 66 patients (84.6%) received corticosteroid. The LDH level was similar in both groups. The corticosteroid group had more adverse outcomes (37.9% vs. 16.7%) despite younger age and less comorbidity. In multivariate analysis, corticosteroid treatment was associated with a 20.7-fold increase in risk of either ICU admission or mortality, independent of age and disease severity.</p>
</sec>
<sec><title>Conclusion</title>
<p>Despite more favourable baseline characteristics and similar peak LDH levels, SARS patients given corticosteroid had more adverse outcomes.</p>
</sec>
</div>
</front>
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