The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study.
The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study.
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DOI：
10.1016/j.jinf.2004.09.008
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发表时间：
2005-08
期刊：
影响因子：
--
通讯作者：
Yeung YM
中科院分区：
文献类型：
--
作者：
Auyeung TW;Lee JS;Lai WK;Choi CH;Lee HK;Lee JS;Li PC;Lok KH;Ng YY;Wong WM;Yeung YM
目的探讨糖皮质激素治疗严重急性呼吸系统综合征（SARS）的疗效。对2003年3月至5月期间在香港一家地区医院连续收治的78名成年SARS患者进行回顾性队列分析，以研究皮质类固醇的有效性。他们根据是否给予皮质类固醇治疗进行分类，并根据人口学特征、合并症、乳酸脱氢酶（LDH）峰值水平和临床结果进行比较。已确定的不良预后因素包括年龄、合并症和高LDH水平被用作多重逻辑回归的协变量，以调整其对不良结局的混杂影响。78例患者中66例（84.6%）接受皮质类固醇治疗。两组LDH水平相似。皮质类固醇组有更多的不良结果（37.9%对16.7%），尽管年龄更小，合并症更少。在多变量分析中，皮质类固醇治疗与ICU入院或死亡风险增加20.7倍相关，与年龄和疾病严重程度无关。尽管更有利的基线特征和相似的LDH峰值水平，给予皮质类固醇的SARS患者有更多的不良后果。
To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS). A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, comorbidities, peak lactate dehydrogenase (LDH) levels and clinical outcomes. Established adverse prognostic factors including old age, comorbidities and high LDH levels were used as covariates in multiple logistic regressions to adjust for their confounding effect on adverse outcomes. Among 78 patients, 66 patients (84.6%) received corticosteroid. The LDH level was similar in both groups. The corticosteroid group had more adverse outcomes (37.9% vs. 16.7%) despite younger age and less comorbidity. In multivariate analysis, corticosteroid treatment was associated with a 20.7-fold increase in risk of either ICU admission or mortality, independent of age and disease severity. Despite more favourable baseline characteristics and similar peak LDH levels, SARS patients given corticosteroid had more adverse outcomes.
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DOI：
10.1016/s0140-6736(03)13077-2
发表时间：
2003-04-19
期刊：
Lancet (London, England)
影响因子：
--
作者：
Peiris JS;Lai ST;Poon LL;Guan Y;Yam LY;Lim W;Nicholls J;Yee WK;Yan WW;Cheung MT;Cheng VC;Chan KH;Tsang DN;Yung RW;Ng TK;Yuen KY;SARS study group
通讯作者：
SARS study group
DOI：
10.1164/rccm.200306-766oc
发表时间：
2003-12-15
影响因子：
24.7
作者：
Ho, JC;Ooi, GC;Tsang, KW
通讯作者：
Tsang, KW
DOI：
10.1001/jama.289.21.joc30885
发表时间：
2003-06-04
影响因子：
120.7
作者：
Booth, CM;Matukas, LM;Detsky, AS
通讯作者：
Detsky, AS
DOI：
10.1016/s0140-6736(03)13265-5
发表时间：
2003-05-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
So LK;Lau AC;Yam LY;Cheung TM;Poon E;Yung RW;Yuen KY
通讯作者：
Yuen KY
影响因子：
39.2
作者：
Choi, KW;Chau, TN;Lai, ST
通讯作者：
Lai, ST