Impact of corticosteroid treatment on clinical outcomes of influenza-associated ARDS: a nationwide multicenter study

Tsai, Ming-Ju; Yang, Kuang-Yao; Chan, Ming-Cheng; Kao, Kuo-Chin; Wang, Hao-Chien; Perng, Wann-Cherng; Wu, Chieh-Liang; Liang, Shinn-Jye; Fang, Wen-Feng; Tsai, Jong-Rung; Chang, Wei-An; Chien, Ying-Chun; Chen, Wei-Chih; Hu, Han-Chung; Lin, Chiung-Yu; Chao, Wen-Cheng; Sheu, Chau-Chyun

doi:10.1186/s13613-020-0642-4

Annals of Intensive Care

Table 1 Characteristics and outcomes between influenza-associated ARDS patients with versus without early corticosteroid treatment

From: Impact of corticosteroid treatment on clinical outcomes of influenza-associated ARDS: a nationwide multicenter study

Variables	Early CS treatment (N = 85)	No early CS treatment (N = 156)	p value
Age	61.0 (56.0–68.0)	59.0 (49.0–65.5)	0.211
Male gender	52 (61.2)	101 (64.7)	0.674
APACHE II score	24.0 (18.0–30.0)	23.0 (17.0–29.0)	0.129
BMI	24.6 (22.1–28.1)	24.8 (21.2–28.1)	0.808
Comorbidity
Malignancy	7 (8.2)	22 (14.1)	0.217
Diabetes	26 (30.6)	43 (27.6)	0.655
Cerebrovascular disease	8 (9.4)	10 (6.4)	0.445
Chronic airway disease	10 (11.8)	11 (7.1)	0.237
End-stage renal disease	7 (8.2)	7 (4.5)	0.257
Congestive heart failure	11 (12.9)	15 (9.6)	0.515
Influenza			0.539
Type A	61 (71.8)	118 (75.6)
Type B	24 (28.2)	38 (24.4)
PaO₂/FiO₂ ratio	87.5 (56.0–142.3)	84.0 (62.0–149.6)	0.670
Severity of ARDS			0.539
Severe ARDS	46 (54.1)	95 (60.9)
Moderate ARDS	32 (37.6)	41 (26.3)
Mild ARDS	7 (8.2)	20 (12.8)
Laboratory data
WBC count, ×10³/μL	9.6 (5.5–15.5)	8.8 (5.9–13.0)	0.253
Hemoglobin, g/dL	12.5 (10.5–14.2)	11.9 (10.0–13.5)	0.102
Platelet count, ×10³/μL	150.0 (108.5–200.5)	149.0 (102.0–210.0)	0.770
Albumin, g/dL	2.9 (2.5–3.3)	2.9 (2.5–3.2)	0.670
C-reactive protein, mg/dL	14.1 (4.2–23.3)	14.9 (6.7–23.0)	0.727
Bacterial coinfections^a	14 (16.5)	17 (10.9)	0.231
Specific treatment
Mechanical ventilation	85 (100.0)	156 (100.0)	0.539
Prone positioning or ECMO	36 (42.4)	56 (35.9)	0.334
Prone positioning	29 (34.1)	29 (18.6)	0.011
ECMO	11 (12.9)	30 (19.2)	0.281
Vasopressor infusion	49 (57.6)	72 (46.2)	0.105
Hemodialysis	16 (18.8)	24 (15.4)	0.587
Clinical outcomes
Hospital mortality	37 (43.5)	30 (19.2)	< 0.001
Hospital days in survivors	24.8 (17.1–40.1)	28.2 (19.1–44.4)	0.475
ICU days in survivors	13.8 (8.4–23.0)	14.8 (9.1–21.8)	0.664
Ventilator days in survivors	11.9 (8.4–25.3)	14.4 (7.8–21.7)	0.953
ICU-free days at Day 28	0.0 (0.0–15.2)	9.2 (0.0–17.6)	0.012
Ventilator-free days at Day 28	0.0 (0.0–17.1)	11.0 (0.0–19.6)	0.009

APACHE II Acute Physiology and Chronic Health Evaluation II, ARDS acute respiratory distress syndrome, BMI body mass index, CS corticosteroid, ECMO extracorporeal membrane oxygenation, FiO₂ fraction of inspired oxygen, PaO₂ partial pressure of arterial oxygen, WBC white blood cell
Statistics are presented as the median (25th–75th percentiles) for continuous variables and as number (%) for categorical variables, as appropriate. p values are calculated by Mann–Whitney U test (or known as Wilcoxon rank sum test) and Chi-square test for continuous and categorical variables, respectively
^aBacterial coinfection was defined as positive bacterial cultures from blood, pleural effusion, lower respiratory tract secretion, or urine samples within 48 h of ARDS diagnosis

Back to article page