Relationship between the Use of Inhaled Steroids for Chronic Respiratory Diseases and Early Outcomes in Community-Acquired Pneumonia
Almirall i Pujol, Jordi (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Bolibar i Ribas, Ignasi (Institut d'Investigació Biomèdica Sant Pau)
Serra-Prat, Mateu (Hospital de Mataró. Consorci Sanitari del Maresme)
Palomera, Elisabet (Hospital de Mataró. Consorci Sanitari del Maresme)
Roig, Jordi (Hospital Nostra Senyora de Meritxell (Principat d'Andorra))
Hospital, Imma (Institut Català de la Salut. Atenció Primària Barcelona Ciutat)
Carandell, Eugenia (Servei de Salut de les Illes Balears)
Agustí, Mercè (Institut Català de la Salut. Atenció Primària Barcelona Ciutat)
Ayuso, Pilar (INSALUD, Valencia)
Estela, Andreu (Servei de Salut de les Illes Balears)
Torres, Antoni (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Universitat Autònoma de Barcelona

Date:	2013
Abstract:	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. 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). 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. 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.
Grants:	Instituto de Salud Carlos III FIS99/0002-01 Ministerio de Sanidad y Consumo CB06/06/0028
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 8 (september 2013) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0073271
PMID: 24039899

7 p, 196.7 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles