Impact of Adjunct Corticosteroid Therapy on Quality of Life for Children With Suspected Pneumonia.
Impact of Adjunct Corticosteroid Therapy on Quality of Life for Children With Suspected Pneumonia.
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DOI：
10.1097/pec.0000000000002984
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发表时间：
2023-07-01
影响因子：
1.4
通讯作者：
中科院分区：
文献类型：
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作者：
目的探讨在急诊科（艾德）出现下呼吸道感染症状和体征并临床怀疑社区获得性肺炎（CAP）的儿童中，糖皮质激素辅助治疗与生活质量（QoL）结局的关系方法对一项前瞻性队列研究进行二次分析，研究对象为年龄3个月至18岁，有LRTI体征和症状，胸部X线检查疑似CAP的儿童，艾德，排除近期（14天内）全身性使用皮质类固醇的儿童。主要暴露是在艾德访视期间接受皮质类固醇。结局为生活质量指标和计划外访视。多变量回归被用来评估皮质类固醇治疗和outcomes.ResultsOf 898名儿童，162（18%）接受皮质类固醇之间的关联。接受糖皮质激素治疗的儿童更常见于男孩（62%）、黑人（45%）、有哮喘史（58%）、既往肺炎史（16%）、喘息（74%）和就诊时病情更严重（6%）。96%的患者接受了哮喘治疗，定义为在急诊室报告哮喘或接受β-受体激动剂治疗。接受皮质类固醇与QoL指标无关：活动缺失天数（校正后的发生率比[aIRR]，0.84; 95%置信区间[CI]，0.63-1.11）和工作缺失天数（aIRR，0.88; 95% CI，0.60-1.27）。年龄（> 2岁）和皮质类固醇治疗之间存在统计学显著的相互作用;患者错过活动的天数较少（aIRR，0.62; 95% CI，0.46-0.83），对2岁或2岁以下儿童无影响（aIRR，0.83; 95% CI，0.54-1.27）。糖皮质激素治疗与计划外访视无关（比值比，1.37; 95%CI，0.69-2.75）。结论：在这一队列的儿童疑似CAP，接受糖皮质激素与哮喘史，并没有与错过的活动或工作天，除了在一个子集的儿童年龄大于2岁。
ObjectiveTo determine the association between adjunct corticosteroid therapy and quality of life (QoL) outcomes in children with signs and symptoms of lower respiratory tract infection and clinical suspicion for community-acquired pneumonia (CAP) in the emergency department (ED).MethodsSecondary analysis from a prospective cohort study of children aged 3 months to 18 years with signs and symptoms of LRTI and a chest radiograph for suspected CAP in the ED, excluding children with recent (within 14 days) systemic corticosteroid use. The primary exposure was receipt of corticosteroids during the ED visit. Outcomes were QoL measures and unplanned visits. Multivariable regression was used to evaluate the association between corticosteroid therapy and outcomes.ResultsOf 898 children, 162 (18%) received corticosteroids. Children who received corticosteroids were more frequently boys (62%), Black (45%), had history of asthma (58%), previous pneumonia (16%), presence of wheeze (74%), and more severe illness at presentation (6%). Ninety-six percent were treated for asthma as defined by report of asthma or receipt of ß-agonist in the ED. Receipt of corticosteroids was not associated with QoL measures: days of activity missed (adjusted incident rate ratio [aIRR], 0.84; 95% confidence interval [CI], 0.63–1.11) and days of work missed (aIRR, 0.88; 95% CI, 0.60–1.27). There was a statistically significant interaction between age (> 2 years) and corticosteroids receipt; the patients had fewer days of activity missed (aIRR, 0.62; 95% CI, 0.46–0.83), with no effect on children 2 years or younger (aIRR, 0.83; 95% CI, 0.54–1.27). Corticosteroid treatment was not associated with unplanned visit (odds ratio, 1.37; 95% CI, 0.69–2.75).ConclusionsIn this cohort of children with suspected CAP, receipt of corticosteroids was associated with asthma history and was not associated with missed days of activity or work, except in a subset of children aged older than 2 years.
DOI：
10.1007/s10096-012-1747-y
发表时间：
2013-03
期刊：
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
影响因子：
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作者：
Principi N;Bianchini S;Baggi E;Esposito S
通讯作者：
Esposito S