Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia.
BACKGROUND: The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP). We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, CO...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3764164?pdf=render |
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| author | Jordi Almirall Ignasi Bolíbar Mateu Serra-Prat Elisabet Palomera Jordi Roig Imma Hospital Eugenia Carandell Mercè Agustí Pilar Ayuso Andreu Estela Antoni Torres Community-Acquired Pneumonia in Catalan Countries (PACAP) |
| author_facet | Jordi Almirall Ignasi Bolíbar Mateu Serra-Prat Elisabet Palomera Jordi Roig Imma Hospital Eugenia Carandell Mercè Agustí Pilar Ayuso Andreu Estela Antoni Torres Community-Acquired Pneumonia in Catalan Countries (PACAP) |
| author_sort | Jordi Almirall |
| collection | DOAJ |
| description | BACKGROUND: The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP). We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, COPD or asthma and CAP may affect early outcome of the acute pneumonic episode. METHODS: Over 1-year period, all population-based cases of CAP in patients with chronic bronchitis, COPD or asthma were registered. Use of inhaled steroids were registered and patients were followed up to 30 days after diagnosis to assess severity of CAP and clinical course (hospital admission, ICU admission and mortality). RESULTS: Of 473 patients who fulfilled the selection criteria, inhaled steroids were regularly used by 109 (23%). In the overall sample, inhaled steroids were associated with a higher risk of hospitalization (OR=1.96, p = 0.002) in the bivariate analysis, but this effect disappeared after adjusting by other severity-related factors (adjusted OR=1.08, p=0.787). This effect on hospitalization also disappeared when considering only patients with asthma (OR=1.38, p=0.542), with COPD alone (OR=4.68, p=0.194), but a protective effect was observed in CB patients (OR=0.15, p=0.027). Inhaled steroids showed no association with ICU admission, days to clinical recovery and mortality in the overall sample and in any disease subgroup. CONCLUSIONS: Treatment with inhaled steroids is not a prognostic factor in COPD and asthmatic patients with CAP, but could prevent hospitalization for CAP in patients with clinical criteria of chronic bronchitis. |
| first_indexed | 2024-12-13T02:33:24Z |
| format | Article |
| id | doaj.art-0ba99e9fbffd493293a25cd5d7e51fcb |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T02:33:24Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-0ba99e9fbffd493293a25cd5d7e51fcb2022-12-22T00:02:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0189e7327110.1371/journal.pone.0073271Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia.Jordi AlmirallIgnasi BolíbarMateu Serra-PratElisabet PalomeraJordi RoigImma HospitalEugenia CarandellMercè AgustíPilar AyusoAndreu EstelaAntoni TorresCommunity-Acquired Pneumonia in Catalan Countries (PACAP)BACKGROUND: The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP). We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, COPD or asthma and CAP may affect early outcome of the acute pneumonic episode. METHODS: Over 1-year period, all population-based cases of CAP in patients with chronic bronchitis, COPD or asthma were registered. Use of inhaled steroids were registered and patients were followed up to 30 days after diagnosis to assess severity of CAP and clinical course (hospital admission, ICU admission and mortality). RESULTS: Of 473 patients who fulfilled the selection criteria, inhaled steroids were regularly used by 109 (23%). In the overall sample, inhaled steroids were associated with a higher risk of hospitalization (OR=1.96, p = 0.002) in the bivariate analysis, but this effect disappeared after adjusting by other severity-related factors (adjusted OR=1.08, p=0.787). This effect on hospitalization also disappeared when considering only patients with asthma (OR=1.38, p=0.542), with COPD alone (OR=4.68, p=0.194), but a protective effect was observed in CB patients (OR=0.15, p=0.027). Inhaled steroids showed no association with ICU admission, days to clinical recovery and mortality in the overall sample and in any disease subgroup. CONCLUSIONS: Treatment with inhaled steroids is not a prognostic factor in COPD and asthmatic patients with CAP, but could prevent hospitalization for CAP in patients with clinical criteria of chronic bronchitis.http://europepmc.org/articles/PMC3764164?pdf=render |
| spellingShingle | Jordi Almirall Ignasi Bolíbar Mateu Serra-Prat Elisabet Palomera Jordi Roig Imma Hospital Eugenia Carandell Mercè Agustí Pilar Ayuso Andreu Estela Antoni Torres Community-Acquired Pneumonia in Catalan Countries (PACAP) Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia. PLoS ONE |
| title | Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia. |
| title_full | Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia. |
| title_fullStr | Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia. |
| title_full_unstemmed | Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia. |
| title_short | Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia. |
| title_sort | relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community acquired pneumonia |
| url | http://europepmc.org/articles/PMC3764164?pdf=render |
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