ArticleCritical care (London, England)2017
Association of baseline steroid use with long-term rates of infection and sepsis in the REGARDS cohort.
Article in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Risk factors for sepsis: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Immunosuppressant heterogeneity and outcomes in total joint arthroplasty: a comparative cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
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- Baseline morbidity and chronic medications as determinants of sepsis outcomes: focus on statins, corticosteroids, and NSAIDs in a population-based cohort of 59,578 patients.Frontiers in pharmacology · 2025Article
- The rates of septicemia in older adults with prostate cancer treated with abiraterone or enzalutamide: A population-based study.Journal of geriatric oncology · 2024Article
- Risk Factors for Secondary Organizing Pneumonia and Acute Fibrinous and Organizing Pneumonia in Patients with COVID-19 Pneumonia.Infection and drug resistance · 2024Article
- Etiology, clinical characteristics, and risk factors associated with severe influenza-like illnesses in Mexican adults.IJID regions · 2023Article
- Clinical outcomes of and risk factors for secondary infection in patients with severe COVID-19: a multicenter cohort study in South Korea.The Korean journal of internal medicine · 2023Article
- Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression.Military Medical Research · 2022Article
- The association between pre-exposure to glucocorticoids and other immunosuppressant drugs with severe COVID-19 outcomes.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022Article
- Perioperative use of intra-articular steroids during the COVID-19 pandemic.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Review
- Risk of nonpulmonary infections requiring hospitalization in spondyloarthritis.Immunity, inflammation and disease · 2022Article
- Trend and Predictors of Short-term Mortality of Adult Bacteremia at Emergency Departments: A 14-Year Cohort Study of 14 625 Patients.Open forum infectious diseases · 2021Article
- Mortality of Sepsis in Patients With Rheumatoid Arthritis: A Single-Center Retrospective Analysis and Comparison With a Control Group.Journal of intensive care medicine · 2021Article
- Prednisolone: role in amoxicillin-clavulanate-induced cholestatic liver injury.BMJ case reports · 2021Article
- Risk of peri-operative complications in children receiving preoperative steroids.Pediatric surgery international · 2020Article
- Mild COVID-19 symptoms despite treatment with teriflunomide and high-dose methylprednisolone due to multiple sclerosis relapse.Journal of neurology · 2020Article
- Management of Allergic Patients During the COVID-19 Pandemic in Asia.Allergy, asthma & immunology research · 2020Review
- COVID-19 infection and glucocorticoids: update from the Italian Society of Endocrinology Expert Opinion on steroid replacement in adrenal insufficiency.Journal of endocrinological investigation · 2020Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPrior studies associate steroid use with infection risk but were limited to select populations and short follow-up periods. The association of steroid use with long-term risk of community-acquired infections is unknown. We sought to determine the association of steroid risk with long-term risks of community- acquired infections and sepsis.
methodsWe used data on 30,239 adults aged ≥ 45 years old from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The primary exposure was oral or injectable steroid use, determined from medication inventory obtained at baseline in-home visit. The primary outcome was time to first infection event during 2003-2012, determined through adjudicated review of hospital records. We determined associations between baseline steroid use and first infection hospitalization events using Cox proportional hazards models, adjusting for demographics, health behaviors, chronic medical conditions, and medication adherence. Among the first infection hospitalization events, we also determined the association between baseline steroid use and sepsis.
resultsSteroid use was reported in 2.24% (n = 677) of the study population. There were 2593 incident infection events during the 10-year follow-up period. Infection incidence rates were higher for steroid than non-steroid users (37.99 vs. 13.79 per 1000 person-years). Steroid use was independently associated with increased risk of infection (adjusted HR 2.10, 95% CI: 1.73-2.56). Among first-infection events, steroid use was associated with increased odds of sepsis (adjusted OR 2.11, 95% CI: 1.33-3.36). The associations persisted in propensity matched analyses as well as models stratified by propensity score and medication adherence.
conclusionsIn this population-based cohort study, baseline steroid use was associated with increased long-term risks of community-acquired infections and sepsis.
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Registered trials
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.