Evidence map›Paper›PMID 26436911›Full record

Observational studyCanadian respiratory journal

Corticosteroid therapy in critical illness due to seasonal and pandemic influenza.

Philippe Yale, Neill K J Adhikari, Vincent Masse, Robert A Fowler, Wei Xiong, Allison McGeer, Darlene Cann, Wallis Rudnick, Karen Green, Maureen O Meade and 2 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Canadian respiratory journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Corticosteroids as adjunctive therapy in the treatment of influenza.The Cochrane database of systematic reviews · 2019
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Philippe Yale
Neill K J Adhikari
Vincent Masse
Robert A Fowler
Wei Xiong
Allison McGeer
Darlene Cann
Wallis Rudnick
Karen Green
Maureen O Meade
Louis Valiquette
François Lamontagne
Mount Sinai Hospital · CAUniversité de Sherbrooke · CAHealth Sciences Centre · CASunnybrook Health Science Centre · CACentre Hospitalier Universitaire de Sherbrooke · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

backgroundSurvey data suggest that Canadian intensivists administer corticosteroids to critically ill patients primarily in response to airway obstruction, perceived risk for adrenal insufficiency and hemodynamic instability.

objectiveTo describe variables independently associated with systemic corticosteroid therapy during an influenza outbreak.

methodsThe present analysis was retrospective cohort study involving critically ill patients with influenza in two Canadian cities. Hospital records were reviewed for critically ill patients treated in the intensive care units (ICUs) of eight hospitals in Canada during the 2008 to 2009 and 2009 to 2010 influenza outbreaks. Abstracted data included demographic information, symptoms at disease onset, chronic comorbidities and baseline illness severity scores. Corticosteroid use data were extracted for every ICU day and expressed as hydrocortisone dose equivalent in mg. Multivariable regression models were constructed to identify variables independently associated with corticosteroid therapy in the ICU.

resultsThe study cohort included 90 patients with a mean (± SD) age of 55.0 ± 17.3 years and Acute Physiology and Chronic Health Evaluation II score of 19.8 ± 8.3. Patients in 2009 to 2010 were younger with more severe lung injury but similar exposure to corticosteroids. Overall, 54% of patients received corticosteroids at a mean daily dose of 343 ± 330 mg of hydrocortisone for 8.5 ± 4.8 days. Variables independently associated with corticosteroid therapy in the ICU were history of airway obstruction (OR 4.8 [95% CI 1.6 to 14.9]) and hemodynamic instability (OR 4.6 [95% CI 1.2 to 17.8]).

conclusionObservational data revealed that hemodynamic instability and airway obstruction were associated with corticosteroid therapy in the critical care setting, similar to a recent survey of stated practice. Efforts to determine the effects of corticosteroids in the ICU for these specific clinical situations are warranted.

Indexed as

Disease OutbreaksPandemicsAdolescentAdrenal Cortex HormonesAdultAgedAged, 80 and overAnti-Inflammatory AgentsCanadaCritical IllnessFemaleHumansInfluenza A Virus, H1N1 SubtypeInfluenza, HumanLogistic ModelsMaleAdrenal Cortex HormonesAnti-Inflammatory Agents

Identifiers

PMID26436911
PMCPMC4596649
OpenAlexW2178864622

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.