Impact of Corticosteroid Administration within 7 Days of the Hospitalization for Influenza Pneumonia with Respiratory Failure: A Propensity Score Analysis Using a Nationwide Administrative Database

Okuno, Daisuke; Kido, Takashi; Muramatsu, Keiji; Tokutsu, Kei; Moriyama, Sakiko; Miyamura, Takuto; Hara, Atsuko; Ishimoto, Hiroshi; Yamaguchi, Hiroyuki; Miyazaki, Taiga; Sakamoto, Noriho; Obase, Yasushi; Ishimatsu, Yuji; Fujino, Yoshihisa; Yatera, Kazuhiro; Matsuda, Shinya; Mukae, Hiroshi

doi:10.3390/jcm10030494

Cited by 9 publications

(13 citation statements)

References 46 publications

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“…[13][14][15][16][17][18] The remaining 14 studies included only sepsis with pneumonia, perforation of the lower gastrointestinal tract, or shock. 12,[19][20][21][22][23][24][25][26][27][28][29][30][31] Four studies on patients with sepsis overall were based on the same cohort [13][14][15][16] (Table 1).…”

Section: R E Su Ltsmentioning

confidence: 99%

“…The claims-based database has population-based statistics on diagnosis, treatment, and medical costs during hospital stays, covering more than 80% of all acute care hospitals in 2019. 12 Using this database, several epidemiological studies have revealed an increasing number of patients with sepsis and an escalating cost of sepsis-related medical care in Japan's super-aging society 13,14 ; however, there is a lack of literature review to obtain a comprehensive understanding of population-based studies in Japan. In this review, we describe the epidemiology, clinical management, and medical costs of patients with sepsis who had an infection and organ dysfunction, which is linked with Sepsis-3 using a Japanese administrative database.…”

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confidence: 99%

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Epidemiology of sepsis in a Japanese administrative database

Imaeda,

Oami,

Takahashi

et al. 2023

Acute Medicine & Surgery

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Sepsis is the leading cause of death worldwide. Considering regional variations in the characteristics of patients with sepsis, a better understanding of the epidemiology in Japan will lead to further development of strategies for the prevention and treatment of sepsis. To investigate the epidemiology of sepsis, we conducted a systematic literature review of PubMed between 2003 and January 2023. Among the 78 studies using a Japanese administrative database, we included 20 that defined patients with sepsis as those with an infection and organ dysfunction. The mortality rate in patients with sepsis has decreased since 2010, reaching 18% in 2017. However, the proportion of inpatients with sepsis is increasing. A study comparing short‐course (≤7 days) and long‐course (≥8 days) antibiotic administration showed lower 28‐day mortality in the short‐course group. Six studies on the treatment of patients with septic shock reported that low‐dose corticosteroids or polymyxin B hemoperfusion reduced mortality, whereas intravenous immunoglobulins had no such effect. Four studies investigating the effects of treatment in patients with sepsis‐associated disseminated intravascular coagulation demonstrated that antithrombin may reduce mortality, whereas recombinant human soluble thrombomodulin does not. A descriptive study of medical costs for patients with sepsis showed that the effective cost per survivor decreased over an 8‐year period from 2010 to 2017. Sepsis has a significant impact on public health, and is attracting attention as an ongoing issue. Further research to determine more appropriate prevention methods and treatment for sepsis should be a matter of priority.

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Section: R E Su Ltsmentioning

confidence: 99%

mentioning

confidence: 99%

Epidemiology of sepsis in a Japanese administrative database

Imaeda,

Oami,

Takahashi

et al. 2023

Acute Medicine & Surgery

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“…A retrospective observational study published in 2021 that used propensity score analysis reported that 25% of the study population received systemic corticosteroids within 7 days of hospital admission. The author found an increased risk of mortality in patients with severe influenza pneumonia, even if corticosteroids were started within this period [ 141 ]. The current recommendations from the American Thoracic Society and Infectious Diseases Society of America are against the use of corticosteroids in adults with severe influenza pneumonia (this is a conditional recommendation with low-quality evidence) [ 122 ].…”

Section: Corticosteroids: Benefit or Harmmentioning

confidence: 99%

Respiratory viruses: their importance and lessons learned from COVID-19

et al. 2022

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Respiratory virus infection can cause severe illnesses capable of inducing acute respiratory failure that can progress rapidly to acute respiratory distress syndrome (ARDS). ARDS is related to poor outcomes, especially in individuals with a higher risk of infection, such as the elderly and those with comorbidities,i.e.obesity, asthma, diabetes mellitus and chronic respiratory or cardiovascular disease. Despite this, effective antiviral treatments available for severe viral lung infections are scarce. The coronavirus disease 2019 (COVID-19) pandemic demonstrated that there is also a need to understand the role of airborne transmission of respiratory viruses. Robust evidence supporting this exists, but better comprehension could help implement adequate measures to mitigate respiratory viral infections. In severe viral lung infections, early diagnosis, risk stratification and prognosis are essential in managing patients. Biomarkers can provide reliable, timely and accessible information possibly helpful for clinicians in managing severe lung viral infections. Although respiratory viruses highly impact global health, more research is needed to improve care and prognosis of severe lung viral infections. In this review, we discuss the epidemiology, diagnosis, clinical characteristics, management and prognosis of patients with severe infections due to respiratory viruses.

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“…68 A retrospective observational study using propensity score analysis suggested that there may be increased risk of mortality even if the corticosteroids are used within 7 days of hospitalization for influenza. 69 Another observational study of 2141 hospitalized patients with influenza showed that low-to-moderate-dose (25–150 mg/day methylprednisolone equivalent) was actually associated with lower mortality compared to no treatment (HR 0.64; 95% CI, 0.43–0.96). 70 However, high-dose corticosteroid therapy resulted in no difference in mortality but in the subgroup of patients with mild disease (PaO 2 /FiO 2 ≥ 300 mmHg) 60-day mortality was increased (HR 3.02; 95% CI, 1.06–8.58).…”

Section: Potential Harms Of Corticosteroidsmentioning

confidence: 99%

Systemic corticosteroids for management of COVID-19: Saving lives or causing harm?

FakhriRavari

Jin

Kachouei

et al. 2021

Int J Immunopathol Pharmacol

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The underlying cause of many complications associated with severe COVID-19 is attributed to the inflammatory cytokine storm that leads to acute respiratory distress syndrome (ARDS), which appears to be the leading cause of death in COVID-19. Systemic corticosteroids have anti-inflammatory activity through repression of pro-inflammatory genes and inhibition of inflammatory cytokines, which makes them a potential medical intervention to diminish the upregulated inflammatory response. Early in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the role of corticosteroids was unclear. Corticosteroid use in other indications such as ARDS and septic shock has proven benefit while its use in other respiratory viral pneumonias is associated with reduced viral clearance and increased secondary infections. This review article evaluates the benefits and harms of systemic corticosteroids in patients with COVID-19 to assist clinicians in improving patient outcomes, including patient safety. Dexamethasone up to 10 days is the preferred regimen to reduce mortality risk in COVID-19 patients requiring oxygen support, mechanical ventilation, or extracorporeal membrane oxygenation. If dexamethasone is unavailable, other corticosteroids can be substituted at equivalent doses. Higher doses of corticosteroids may be beneficial in patients who develop ARDS. Corticosteroids should be avoided early in the disease course when patients do not require oxygen support because of potential harms.

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Impact of Corticosteroid Administration within 7 Days of the Hospitalization for Influenza Pneumonia with Respiratory Failure: A Propensity Score Analysis Using a Nationwide Administrative Database

Cited by 9 publications

References 46 publications

Epidemiology of sepsis in a Japanese administrative database

Epidemiology of sepsis in a Japanese administrative database

Respiratory viruses: their importance and lessons learned from COVID-19

Systemic corticosteroids for management of COVID-19: Saving lives or causing harm?

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