Observational studyIntensive care medicine2018
Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study.
Observational study in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 7 of them syntheses that pooled 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.
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.
Who cites it
88 citing papers in PubMed, 7 syntheses or guidelines pooled it, 167 citations in OpenAlex.
- Association between Glucocorticoids and Mortality in Patients with Severe Pneumonia: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials.Computational and mathematical methods in medicine · 2022Pooled it
- Pooled it
- Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Pooled it
- Use of corticosteroids in influenza-associated acute respiratory distress syndrome and severe pneumonia: a systemic review and meta-analysis.Scientific reports · 2020Pooled it
- Efficacy and Safety of Corticosteroid Treatment in Patients With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2020Pooled it
- The effect of corticosteroids on mortality of patients with influenza pneumonia: a systematic review and meta-analysis.Critical care (London, England) · 2019Pooled it
- Corticosteroids as adjunctive therapy in the treatment of influenza.The Cochrane database of systematic reviews · 2019Pooled it
- Trial
- A clinician's guide to corticosteroid therapy in pneumonia and critical illness: agent selection, dosing, monitoring, and interactions.Pneumonia (Nathan Qld.) · 2026Review
- Corticosteroids in immunocompromised ICU patients with pneumonia: risks, evidence, and clinical practice.Pneumonia (Nathan Qld.) · 2026Review
- Corticosteroids for severe influenza pneumonia: a persistent evidence gap. Author's reply.Intensive care medicine · 2026Article
- The heterogeneous treatment effect of adjuvant therapy with corticosteroids in patients with Community-Acquired Pneumonia: a review.Pneumonia (Nathan Qld.) · 2026Review
- Biomarker-guided use of corticosteroids in pneumonia.Pneumonia (Nathan Qld.) · 2026Review
- The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza.Pneumonia (Nathan Qld.) · 2026Review
- Glucocorticoid Treatment in Community-Acquired Pneumonia.Seminars in respiratory and critical care medicine · 2026Review
- Review
- Corticosteroids and hospital-acquired pneumonia.Pneumonia (Nathan Qld.) · 2025Review
- Current corticosteroid therapeutic strategy for community-acquired pneumonia in adults: indications, dosage, and timing.Journal of intensive care · 2025Review
- Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies.Signal transduction and targeted therapy · 2025Review
- Clinical features and factors associated with outcomes of antibody-negative autoimmune encephalitis in patients requiring intensive care.Critical care (London, England) · 2025Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
21 authors at 16 institutions in 3 countries.
Funding
Abstract
purposeTo determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia.
methodsSecondary analysis of a prospective cohort study of critically ill patients with confirmed influenza pneumonia admitted to 148 ICUs in Spain between June 2009 and April 2014. Patients who received corticosteroid treatment for causes other than viral pneumonia (e.g., refractory septic shock and asthma or chronic obstructive pulmonary disease [COPD] exacerbation) were excluded. Patients with corticosteroid therapy were compared with those without corticosteroid therapy. We use a propensity score (PS) matching analysis to reduce confounding factors. The primary outcome was ICU mortality. Cox proportional hazards and competing risks analysis was performed to assess the impact of corticosteroids on ICU mortality.
resultsA total of 1846 patients with primary influenza pneumonia were enrolled. Corticosteroids were administered in 604 (32.7%) patients, with methylprednisolone the most frequently used corticosteroid (578/604 [95.7%]). The median daily dose was equivalent to 80 mg of methylprednisolone (IQR 60-120) for a median duration of 7 days (IQR 5-10). Asthma, COPD, hematological disease, and the need for mechanical ventilation were independently associated with corticosteroid use. Crude ICU mortality was higher in patients who received corticosteroids (27.5%) than in patients who did not receive corticosteroids (18.8%, p < 0.001). After PS matching, corticosteroid use was associated with ICU mortality in the Cox (HR = 1.32 [95% CI 1.08-1.60], p < 0.006) and competing risks analysis (SHR = 1.37 [95% CI 1.12-1.68], p = 0.001).
conclusionAdministration of corticosteroids in patients with severe influenza pneumonia is associated with increased ICU mortality, and these agents should not be used as co-adjuvant therapy.
Indexed as
Identifiers
What OpenQuestion holds
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.