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
Abstract
:1. Introduction
2. Experimental Section
2.1. Data Source
2.2. Patient Selection
2.3. Variables
2.4. OUTCOMES
2.5. STATISTICAL ANALYSIS
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- Yang, J.W.; Fan, L.C.; Miao, X.Y.; Mao, B.; Li, M.H.; Lu, H.W.; Liang, S.; Xu, J.F. Corticosteroids for the treatment of human infection with influenza virus: A systematic review and meta-analysis. Clin. Microbiol. Infect. 2015, 21, 956–963. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Webb, S.A.; Pettilä, V.; Seppelt, I.; Bellomo, R.; Bailey, M.; Cooper, D.J.; Cretikos, M.; Davies, A.R.; Finfer, S.; Harrigan, P.W.; et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N. Engl. J. Med. 2009, 361, 1925–1934. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jain, S.; Kamimoto, L.; Bramley, A.M.; Schmitz, A.M.; Benoit, S.R.; Louie, J.; Sugerman, D.E.; Druckenmiller, J.K.; Ritger, K.A.; Chugh, R.; et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April–June 2009. N. Engl. J. Med. 2009, 361, 1935–1944. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Quispe-Laime, A.M.; Bracco, J.D.; Barberio, P.A.; Campagne, C.G.; Rolfo, V.E.; Umberger, R.; Meduri, G.U. H1N1 influenza A virus-associated acute lung injury: Response to combination oseltamivir and prolonged corticosteroid treatment. Intensive Care Med. 2010, 36, 33–41. [Google Scholar] [CrossRef]
- de Jong, M.D.; Simmons, C.P.; Thanh, T.T.; Hien, V.M.; Smith, G.J.; Chau, T.N.; Hoang, D.M.; Chau, N.V.; Khanh, T.H.; Dong, V.C.; et al. Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia. Nat. Med. 2006, 12, 1203–1207. [Google Scholar] [CrossRef]
- Bermejo-Martin, J.F.; Ortiz de Lejarazu, R.; Pumarola, T.; Rello, J.; Almansa, R.; Ramírez, P.; Martin-Loeches, I.; Varillas, D.; Gallegos, M.C.; Serón, C.; et al. Th1 and Th17 hypercytokinemia as early host response signature in severe pandemic influenza. Crit. Care 2009, 13, R201. [Google Scholar] [CrossRef] [Green Version]
- Takano, T.; Tajiri, H.; Kashiwagi, Y.; Kimura, S.; Kawashima, H. Cytokine and chemokine response in children with the 2009 pandemic influenza A (H1N1) virus infection. Eur. J. Clin. Microbiol. Infect. Dis. 2011, 30, 117–120. [Google Scholar] [CrossRef] [Green Version]
- Póvoa, P.; Salluh, J.I. What is the role of steroids in pneumonia therapy? Curr. Opin. Infect. Dis. 2012, 25, 199–204. [Google Scholar] [CrossRef]
- Blum, C.A.; Nigro, N.; Briel, M.; Schuetz, P.; Ullmer, E.; Suter-Widmer, I.; Winzeler, B.; Bingisser, R.; Elsaesser, H.; Drozdov, D.; et al. Adjunct prednisone therapy for patients with community-acquired pneumonia: A multicentre, double-blind, randomised, placebo-controlled trial. Lancet 2015, 385, 1511–1518. [Google Scholar] [CrossRef]
- Torres, A.; Sibila, O.; Ferrer, M.; Polverino, E.; Menendez, R.; Mensa, J.; Gabarrus, A.; Sellares, J.; Restrepo, M.I.; Anzueto, A.; et al. Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: A randomized clinical trial. JAMA 2015, 313, 677–686. [Google Scholar] [CrossRef] [Green Version]
- Kellum, J.A.; Kong, L.; Fink, M.P.; Weissfeld, L.A.; Yealy, D.M.; Pinsky, M.R.; Fine, J.; Krichevsky, A.; Delude, R.L.; Angus, D.C.; et al. Understanding the inflammatory cytokine response in pneumonia and sepsis: Results of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Study. Arch. Intern. Med. 2007, 167, 1655–1663. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tang, B.M.; Craig, J.C.; Eslick, G.D.; Seppelt, I.; McLean, A.S. Use of corticosteroids in acute lung injury and acute respiratory distress syndrome: A systematic review and meta-analysis. Crit. Care Med. 2009, 37, 1594–1603. [Google Scholar] [CrossRef] [PubMed]
- Cheng, M.; Pan, Z.Y.; Yang, J.; Gao, Y.D. Corticosteroid therapy for severe community-acquired pneumonia: A meta-analysis. Respir. Care 2014, 59, 557–563. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nie, W.; Zhang, Y.; Cheng, J.; Xiu, Q. Corticosteroids in the treatment of community-acquired pneumonia in adults: A meta-analysis. PLoS ONE 2012, 7, e47926. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Group, R.C.; Horby, P.; Lim, W.S.; Emberson, J.R.; Mafham, M.; Bell, J.L.; Linsell, L.; Staplin, N.; Brightling, C.; Ustianowski, A.; et al. Dexamethasone in Hospitalized Patients with Covid-19—Preliminary Report. N. Engl. J. Med. 2020. [Google Scholar] [CrossRef]
- Boudreault, A.A.; Xie, H.; Leisenring, W.; Englund, J.; Corey, L.; Boeckh, M. Impact of corticosteroid treatment and antiviral therapy on clinical outcomes in hematopoietic cell transplant patients infected with influenza virus. Biol. Blood Marrow Transpl. 2011, 17, 979–986. [Google Scholar] [CrossRef] [Green Version]
- Diaz, E.; Martin-Loeches, I.; Canadell, L.; Vidaur, L.; Suarez, D.; Socias, L.; Estella, A.; Gil Rueda, B.; Guerrero, J.E.; Valverdu-Vidal, M.; et al. Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza. J. Infect. 2012, 64, 311–318. [Google Scholar] [CrossRef]
- Xi, X.; Xu, Y.; Jiang, L.; Li, A.; Duan, J.; Du, B.; Chinese Critical Care Clinical Trial, G. Hospitalized adult patients with 2009 influenza A(H1N1) in Beijing, China: Risk factors for hospital mortality. BMC Infect. Dis. 2010, 10, 256. [Google Scholar] [CrossRef] [Green Version]
- Martin-Loeches, I.; Lisboa, T.; Rhodes, A.; Moreno, R.P.; Silva, E.; Sprung, C.; Chiche, J.D.; Barahona, D.; Villabon, M.; Balasini, C.; et al. Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection. Intensive Care Med. 2011, 37, 272–283. [Google Scholar] [CrossRef]
- Kim, S.H.; Hong, S.B.; Yun, S.C.; Choi, W.I.; Ahn, J.J.; Lee, Y.J.; Lee, H.B.; Lim, C.M.; Koh, Y.; Korean Society of Critical Care Medicine, H.N.C. Corticosteroid treatment in critically ill patients with pandemic influenza A/H1N1 2009 infection: Analytic strategy using propensity scores. Am. J. Respir. Crit. Care Med. 2011, 183, 1207–1214. [Google Scholar] [CrossRef]
- Brun-Buisson, C.; Richard, J.C.; Mercat, A.; Thiebaut, A.C.; Brochard, L.; Group, R.-S.A.H.N.v.R. Early corticosteroids in severe influenza A/H1N1 pneumonia and acute respiratory distress syndrome. Am. J. Respir. Crit. Care Med. 2011, 183, 1200–1206. [Google Scholar] [CrossRef] [PubMed]
- Cao, B.; Gao, H.; Zhou, B.; Deng, X.; Hu, C.; Deng, C.; Lu, H.; Li, Y.; Gan, J.; Liu, J.; et al. Adjuvant Corticosteroid Treatment in Adults With Influenza A (H7N9) Viral Pneumonia. Crit. Care Med. 2016, 44, e318–e328. [Google Scholar] [CrossRef] [PubMed]
- Tsai, M.J.; Yang, K.Y.; Chan, M.C.; Kao, K.C.; Wang, H.C.; Perng, W.C.; Wu, C.L.; Liang, S.J.; Fang, W.F.; Tsai, J.R.; et al. Impact of corticosteroid treatment on clinical outcomes of influenza-associated ARDS: A nationwide multicenter study. Ann. Intensive Care 2020, 10, 26. [Google Scholar] [CrossRef]
- Domínguez-Cherit, G.; Lapinsky, S.E.; Macias, A.E.; Pinto, R.; Espinosa-Perez, L.; de la Torre, A.; Poblano-Morales, M.; Baltazar-Torres, J.A.; Bautista, E.; Martinez, A.; et al. Critically Ill patients with 2009 influenza A(H1N1) in Mexico. JAMA 2009, 302, 1880–1887. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kumar, A.; Zarychanski, R.; Pinto, R.; Cook, D.J.; Marshall, J.; Lacroix, J.; Stelfox, T.; Bagshaw, S.; Choong, K.; Lamontagne, F.; et al. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA 2009, 302, 1872–1879. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kurita, T.; Yasuda, S.; Oba, K.; Odani, T.; Kono, M.; Otomo, K.; Fujieda, Y.; Oku, K.; Bohgaki, T.; Amengual, O.; et al. The efficacy of tacrolimus in patients with interstitial lung diseases complicated with polymyositis or dermatomyositis. Rheumatology (Oxford) 2015, 54, 39–44. [Google Scholar] [CrossRef] [Green Version]
- Robins, J.M.; Hernán, M.A.; Brumback, B. Marginal structural models and causal inference in epidemiology. Epidemiology 2000, 11, 550–560. [Google Scholar] [CrossRef]
- Lunceford, J.K.; Davidian, M. Stratification and weighting via the propensity score in estimation of causal treatment effects: A comparative study. Stat. Med. 2004, 23, 2937–2960. [Google Scholar] [CrossRef]
- Morshed, S.; Knops, S.; Jurkovich, G.J.; Wang, J.; MacKenzie, E.; Rivara, F.P. The impact of trauma-center care on mortality and function following pelvic ring and acetabular injuries. J. Bone Joint Surg. Am. 2015, 97, 265–272. [Google Scholar] [CrossRef]
- Matsuda, S. Development of Case Mix Based Evaluation System in Japan. Jpn. Hosp. 2016, 35–44. [Google Scholar]
- Yasunaga, H.; Hashimoto, H.; Horiguchi, H.; Miyata, H.; Matsuda, S. Variation in cancer surgical outcomes associated with physician and nurse staffing: A retrospective observational study using the Japanese Diagnosis Procedure Combination Database. BMC Health Serv. Res. 2012, 12, 129. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chikuda, H.; Yasunaga, H.; Takeshita, K.; Horiguchi, H.; Kawaguchi, H.; Ohe, K.; Fushimi, K.; Tanaka, S. Mortality and morbidity after high-dose methylprednisolone treatment in patients with acute cervical spinal cord injury: A propensity-matched analysis using a nationwide administrative database. Emerg. Med. J. 2014, 31, 201–206. [Google Scholar] [CrossRef] [PubMed]
- Iwagami, M.; Yasunaga, H.; Doi, K.; Horiguchi, H.; Fushimi, K.; Matsubara, T.; Yahagi, N.; Noiri, E. Postoperative polymyxin B hemoperfusion and mortality in patients with abdominal septic shock: A propensity-matched analysis. Crit. Care Med. 2014, 42, 1187–1193. [Google Scholar] [CrossRef] [PubMed]
- Kido, T.; Muramatsu, K.; Asakawa, T.; Otsubo, H.; Ogoshi, T.; Oda, K.; Kubo, T.; Fujino, Y.; Matsuda, S.; Mayumi, T.; et al. The relationship between high-dose corticosteroid treatment and mortality in acute respiratory distress syndrome: A retrospective and observational study using a nationwide administrative database in Japan. BMC Pulm. Med. 2018, 18, 28. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Muramatsu, K.; Fujino, Y.; Kubo, T.; Otani, M.; Fushimi, K.; Matsuda, S. Efficacy of Antimicrobial Catheters for Prevention of Catheter-Associated Urinary Tract Infection in Acute Cerebral Infarction. J. Epidemiol. 2018, 28, 54–58. [Google Scholar] [CrossRef] [Green Version]
- Kido, T.; Muramatsu, K.; Yatera, K.; Asakawa, T.; Otsubo, H.; Kubo, T.; Fujino, Y.; Matsuda, S.; Mayumi, T.; Mukae, H. Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome. Respirology 2017, 22, 708–713. [Google Scholar] [CrossRef]
- Ricard, J.D.; Messika, J. Low-dose corticosteroids during severe community-acquired pneumonia: End of the story. Eur. Respir. J. 2015, 45, 305–307. [Google Scholar] [CrossRef] [Green Version]
- Horita, N.; Hashimoto, S.; Miyazawa, N.; Fujita, H.; Kojima, R.; Inoue, M.; Ueda, A.; Ishigatsubo, Y.I.; Kaneko, T. Impact of Corticosteroids on Mortality in Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-analysis. Intern. Med. 2015, 54, 1473–1479. [Google Scholar] [CrossRef] [Green Version]
- Hochberg, Y. A sharper Bonferroni procedure for multiple tests of significance. Biometrika 1988, 75, 800–802. [Google Scholar] [CrossRef]
- Sprung, C.L.; Annane, D.; Keh, D.; Moreno, R.; Singer, M.; Freivogel, K.; Weiss, Y.G.; Benbenishty, J.; Kalenka, A.; Forst, H.; et al. Hydrocortisone therapy for patients with septic shock. N. Engl. J. Med. 2008, 358, 111–124. [Google Scholar] [CrossRef] [Green Version]
- Dehoux, M.S.; Boutten, A.; Ostinelli, J.; Seta, N.; Dombret, M.C.; Crestani, B.; Deschenes, M.; Trouillet, J.L.; Aubier, M. Compartmentalized cytokine production within the human lung in unilateral pneumonia. Am. J. Respir. Crit. Care Med. 1994, 150, 710–716. [Google Scholar] [CrossRef] [PubMed]
- Lee, N.; Allen Chan, K.C.; Hui, D.S.; Ng, E.K.; Wu, A.; Chiu, R.W.; Wong, V.W.; Chan, P.K.; Wong, K.T.; Wong, E.; et al. Effects of early corticosteroid treatment on plasma SARS-associated Coronavirus RNA concentrations in adult patients. J. Clin. Virol. 2004, 31, 304–309. [Google Scholar] [CrossRef] [PubMed]
- Jung, K.; Alekseev, K.P.; Zhang, X.; Cheon, D.S.; Vlasova, A.N.; Saif, L.J. Altered pathogenesis of porcine respiratory coronavirus in pigs due to immunosuppressive effects of dexamethasone: Implications for corticosteroid use in treatment of severe acute respiratory syndrome coronavirus. J. Virol. 2007, 81, 13681–13693. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Salomon, R.; Hoffmann, E.; Webster, R.G. Inhibition of the cytokine response does not protect against lethal H5N1 influenza infection. Proc. Natl. Acad. Sci. USA 2007, 104, 12479–12481. [Google Scholar] [CrossRef] [Green Version]
- Hamada, T.; Yasunaga, H.; Nakai, Y.; Isayama, H.; Horiguchi, H.; Matsuda, S.; Fushimi, K.; Koike, K. Continuous regional arterial infusion for acute pancreatitis: A propensity score analysis using a nationwide administrative database. Crit. Care 2013, 17, R214. [Google Scholar] [CrossRef] [Green Version]
Baseline Characteristics | Before Adjustment | After Adjustment | ||||
---|---|---|---|---|---|---|
Variables | Corticosteroid n = 875 | Non-Corticosteroid n = 2644 | p-Value | Corticosteroid n = 875 | Non-Corticosteroid n = 2644 | p-Value |
Age, years | 62.9 ± 1.0 | 71.8 ± 0.5 | <0.001 | 68.4 ± 0.7 | 69.3 ± 0.5 | 0.068 |
Sex (Female) | 41.4 | 44.4 | 0.113 | 45.4 | 43.6 | 0.136 |
Advanced treatment hospital | 10.4 | 7.5 | 0.006 | 8.0 | 8.4 | 0.421 |
Emergency admission | 74.9 | 70.5 | 0.012 | 73.2 | 71.6 | 0.130 |
Emergency transport | 55.5 | 59.2 | 0.055 | 55.9 | 57.3 | 0.200 |
Home healthcare | 6.6 | 10.9 | <0.001 | 9.3 | 9.7 | 0.599 |
Hospital volume | 12.9 ± 0.7 | 14.1 ± 0.5 | 0.110 | 12.9 ± 0.6 | 13.6 ± 0.4 | 0.110 |
Pregnancy | 0 | 0.04 | 0.565 | 0 | 0.03 | 0.317 |
Smoking | 37.5 | 34.9 | 0.174 | 35.2 | 36.3 | 0.284 |
Asthma | 27.2 | 8.2 | <0.001 | 13.9 | 14.0 | 0.851 |
Cancer | 8.6 | 8.1 | 0.682 | 8.6 | 8.4 | 0.766 |
Cardiovascular disease | 3.5 | 5.0 | 0.084 | 4.4 | 4.9 | 0.459 |
Cerebrovascular disease | 6.4 | 11.2 | <0.001 | 9.8 | 9.6 | 0.812 |
Chronic kidney disease | 9.8 | 9.4 | 0.695 | 9.2 | 9.5 | 0.640 |
Chronic respiratory failure | 3.2 | 2.0 | 0.034 | 2.7 | 2.2 | 0.095 |
COPD | 12.2 | 5.8 | <0.001 | 8.2 | 8.2 | 0.992 |
Diabetes mellitus | 18.4 | 17.1 | 0.378 | 19.1 | 18.4 | 0.547 |
Liver dysfunction | 29.7 | 16.3 | 0.013 | 22.4 | 18.4 | 0.045 |
Neurological dysfunction | 6.7 | 5.5 | 0.167 | 5.7 | 6.1 | 0.553 |
Heart failure | 12.9 | 17.4 | 0.002 | 15.9 | 15.5 | 0.624 |
Hypertension | 19.8 | 25.7 | <0.001 | 23.8 | 24.3 | 0.686 |
Interstitial lung disease | 18.7 | 11.3 | <0.001 | 13.0 | 13.2 | 0.666 |
Albumin | 10.1 | 3.1 | 0.001 | 5.1 | 5.5 | 0.467 |
Antithrombin III | 3.4 | 0.6 | <0.001 | 1.6 | 1.8 | 0.624 |
Heparin | 21.1 | 10.6 | <0.001 | 13.0 | 13.7 | 0.276 |
Immunoglobulin | 4.7 | 1.5 | <0.001 | 3.3 | 2.9 | 0.550 |
Insulin | 31.2 | 12.8 | <0.001 | 18.0 | 18.1 | 0.877 |
Platelet transfusion | 4.0 | 1.1 | <0.001 | 2.4 | 2.7 | 0.625 |
Red cell transfusion | 6.1 | 2.8 | <0.001 | 4.5 | 4.2 | 0.575 |
rhTM | 5.9 | 1.2 | <0.001 | 2.7 | 2.6 | 0.796 |
Sivelestat | 1.7 | 0.5 | 0.001 | 1.0 | 0.9 | 0.514 |
Vasopressor | 23.3 | 10.7 | <0.001 | 14.0 | 14.3 | 0.565 |
Oseltamivir | 10.2 | 9.7 | 0.698 | 10.7 | 10.0 | 0.380 |
Zanamivir | 0.7 | 0.1 | 0.001 | 0.3 | 0.5 | 0.378 |
Laninamivir | 1.6 | 2.5 | 0.110 | 2.6 | 2.2 | 0.388 |
Peramivir | 67.1 | 60.6 | 0.001 | 61.6 | 62.3 | 0.550 |
Azithromycin (iv) | 9.3 | 3.6 | <0.001 | 4.6 | 4.6 | 0.920 |
Azithromycin (oral) | 0.1 | 0.4 | 0.119 | 0.4 | 0.4 | 0.549 |
Clarithromycin | 5.2 | 3.7 | 0.045 | 4.2 | 4.2 | 0.908 |
Erythromycin (oral) | 0.9 | 0.4 | 0.081 | 0.7 | 0.8 | 0.601 |
Erythromycin (iv) | 0.1 | 0.04 | 0.411 | 0.05 | 0.05 | 0.854 |
Carbapenem (iv) | 19.5 | 10.4 | <0.001 | 13.0 | 13.4 | 0.481 |
Cephalosporin (1st generation, iv) | 0.9 | 1.3 | 0.380 | 1.6 | 1.3 | 0.578 |
Cephalosporin (2ndgeneration, iv) | 1.4 | 1.6 | 0.598 | 1.1 | 1.5 | 0.114 |
Cephalosporin (3rdgeneration, iv) | 32.2 | 32.2 | 0.998 | 33.0 | 32.0 | 0.337 |
Cephalosporin (4thgeneration, iv) | 1.8 | 1.5 | 0.518 | 1.7 | 1.8 | 0.680 |
Clindamycin (iv) | 0.7 | 0.6 | 0.693 | 0.8 | 0.5 | 0.400 |
Minocycline (iv) | 2.5 | 1.9 | 0.228 | 2.5 | 2.1 | 0.293 |
Metronidazole (oral) | 0.3 | 0.2 | 0.556 | 0.3 | 0.2 | 0.401 |
New quinolone (iv) | 12.9 | 6.0 | <0.001 | 9.1 | 8.6 | 0.466 |
New quinolone (oral) | 5.9 | 5.2 | 0.387 | 5.4 | 5.7 | 0.580 |
Penicillin antibiotics | 35.9 | 37.3 | 0.467 | 37.1 | 37.0 | 0.891 |
anti-MRSA drug (iv) | 3.9 | 1.2 | <0.001 | 2.0 | 2.0 | 0.929 |
Emergency hemodialysis | 0.6 | 1.0 | 0.258 | 0.7 | 0.9 | 0.377 |
Maintenance hemodialysis | 14.9 | 25.7 | 0.063 | 1.8 | 2.2 | 0.177 |
ECMO | 0 | 0.1 | 0.319 | 0 | 0.08 | 0.083 |
IMV wearing days | 1.5 ± 0.1 | 0.5 ± 0.0 | <0.001 | 0.8 ± 0.0 | 0.8 ± 0.0 | 0.754 |
NPPV | 1.5 | 0.6 | 0.008 | 0.9 | 0.8 | 0.391 |
Oxygen therapy | 82.2 | 92.9 | <0.001 | 90.4 | 90.1 | 0.526 |
PMX | 0.3 | 0.04 | 0.020 | 0.1 | 0.09 | 0.352 |
ICU admission rate | 11.5 | 4.6 | <0.001 | 6.9 | 7.3 | 0.499 |
Outcomes | Corticosteroid | Non-Corticosteroid | p-Value |
---|---|---|---|
30-day mortality (%) | 14.52 | 13.38 | 0.454 |
90-day mortality (%) | 18.43 | 15.08 | 0.054 |
In-hospital mortality (%) | 19.21 | 15.36 | 0.031 |
ICU management, mean days (SE) | 0.60 (0.08) | 0.58 (0.07) | 0.857 |
IMV, mean days (SE) | 2.13 (0.23) | 2.39 (0.23) | 0.373 |
Hospital stay, mean days (SE) | 19.90 (1.07) | 19.38 (0.44) | 0.649 |
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Okuno, D.; Kido, T.; Muramatsu, K.; Tokutsu, K.; Moriyama, S.; Miyamura, T.; Hara, A.; Ishimoto, H.; Yamaguchi, H.; Miyazaki, T.; et al. 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. J. Clin. Med. 2021, 10, 494. https://doi.org/10.3390/jcm10030494
Okuno D, Kido T, Muramatsu K, Tokutsu K, Moriyama S, Miyamura T, Hara A, Ishimoto H, Yamaguchi H, Miyazaki T, et al. 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. Journal of Clinical Medicine. 2021; 10(3):494. https://doi.org/10.3390/jcm10030494
Chicago/Turabian StyleOkuno, Daisuke, Takashi Kido, Keiji Muramatsu, Kei Tokutsu, Sakiko Moriyama, Takuto Miyamura, Atsuko Hara, Hiroshi Ishimoto, Hiroyuki Yamaguchi, Taiga Miyazaki, and et al. 2021. "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" Journal of Clinical Medicine 10, no. 3: 494. https://doi.org/10.3390/jcm10030494