Analysis of systemic corticosteroid usage and survival in patients requiring mechanical ventilation for severe community-acquired pneumonia

摘要

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, 1.019e4), 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.