Prehospital use of inhaled steroids and incidence of acute lung injury among patients at risk
| Autor: | Emir, Festic, Enrique, Ortiz-Diaz, Augustine, Lee, Guangxi, Li, Daryl J, Kor, Adesanya, Adebola, Ozan, Akca, Jason, Hoth, Joseph E, Levitt, Rickey, Carter, Ognjen, Gajic, Mauricio, Garcia |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Acute Lung Injury Population Lung injury Critical Care and Intensive Care Medicine Article Adrenal Cortex Hormones Risk Factors Internal medicine Administration Inhalation Humans Medicine Risk factor Propensity Score education APACHE Aged Mechanical ventilation education.field_of_study business.industry Incidence Incidence (epidemiology) Middle Aged United States Confidence interval Anesthesia Propensity score matching Cohort Female business |
| Zdroj: | Journal of Critical Care. 28:985-991 |
| ISSN: | 0883-9441 |
| DOI: | 10.1016/j.jcrc.2013.08.011 |
| Popis: | article i nfo Purpose: Inhaled corticosteroids (ICSs) attenuated lung injury in animal studies. We investigated the association between prehospital ICS and incidence of acute lung injury (ALI) among patients at risk. Methods: In this ancillary analysis of the large multicenter Lung Injury Prediction Study cohort, we developed a propensity score for prehospital ICS use followed by matching, for all patients and for a subgroup of patients with at least 1 risk factor for direct pulmonary injury. The primary outcome was ALI; secondary outcomes included acute respiratory distress syndrome, need for invasive mechanical ventilation, and hospital mortality. Results: Of the 5126 patients, 401 (8%) were using ICS. Acute lung injury developed in 343 (7%). The unadjusted incidence of ALI was 4.7% vs 6.9% (P = .12) among those in ICS compared with non-ICS group. In the "direct" lunginjury subgroup, the unadjusted incidenceof ALIwas 4.1%vs10.6%(P= 0.006).After propensity matching, the estimated effectfor ALIinthewhole cohortwas 0.69 (95%confidence interval, 0.39-1.2;P= .18),and thatin the direct subgroup was 0.56 (95% confidence interval, 0.22-1.46; P = .24). Conclusions: Preadmission use of ICS in a hospitalized population of patients at risk for ALI was not significantly associated with a lower incidence of ALI once controlled by comprehensive propensity-matched analysis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect