Complications of Oral Corticosteroid Use in Otolaryngology.
| Autor: | Mitchell MB; Harvard Medical School, Boston, MA, USA.; Department of Otolaryngology, Massachusetts Eye & Ear, Boston, MA, USA., Workman AD; Harvard Medical School, Boston, MA, USA.; Department of Otolaryngology, Massachusetts Eye & Ear, Boston, MA, USA., Bhattacharyya N; Harvard Medical School, Boston, MA, USA.; Department of Otolaryngology, Massachusetts Eye & Ear, Boston, MA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2025 Jan; Vol. 134 (1), pp. 9-13. Date of Electronic Publication: 2024 Sep 24. |
| DOI: | 10.1177/00034894241282577 |
| Abstrakt: | Objective: Oral corticosteroids (OCS) are frequently prescribed by otolaryngologists. However, there are limited quantitative data on OCS-related adverse events (AEs) in otolaryngology. We sought to quantify OCS-related AEs in otolaryngology. Methods: All outpatient otolaryngology encounters in our healthcare system (2018-2023) at which an OCS was prescribed were identified via the electronic medical record. The diagnoses indicating OCS were categorized as sinonasal, otologic, pharyngo-laryngeal, and other. The medical record was subsequently examined to assess for OCS AEs during the 21-day period following the prescription. OCS AEs were grouped into (1) gastrointestinal, (2) metabolic, (3) bone/muscle, (4) ophthalmologic, and/or (5) psychiatric complications. The frequency and types of OCS related AEs were determined. Results: A total of 20 746 otolaryngology encounters with OCS prescribed were examined. Seventy OCS courses had 1 or more AEs, implying a number needed to harm of 296.4 (240.2-386.8). There were 83 total OCS-related AEs, yielding an AE incidence rate of 4.0:1000 (95% CI, 3.0-5.0:1000) OCS prescriptions. The mean age of subjects with AEs (61.5 years) was significantly higher than those without (50.3 years; P < .001). Forty-seven (56.6%) of the complications were metabolic, with hyperglycemia and hypokalemia the most common, followed by gastrointestinal (26.5%), ophthalmologic (3.6%), psychiatric (2.4%), and musculoskeletal (2.4%). Conclusion: AEs related to OCS prescribed by otolaryngologists occur at a rate of once per 296 courses of treatment and older populations may be at increased risk for AEs. Otolaryngologists should balance AE rates against anticipated benefits of steroid therapy. Level of Evidence: 3. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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