Evidence map›Paper›PMID 40665428›Full record

ArticleJournal of intensive care2025

Mortality of severe pneumonia treated with methylprednisolone versus hydrocortisone: a propensity-matched analysis.

Takuya Sato, Yusuke Sasabuchi, Ryota Inokuchi, Shotaro Aso, Hideo Yasunaga, Kent Doi

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

6 authors.

Takuya SatoDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1138655, Japan. satot-eme88@g.ecc.u-tokyo.ac.jp.
Yusuke SasabuchiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1138655, Japan.
Ryota InokuchiDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1138655, Japan.
Shotaro AsoDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1138655, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1138655, Japan.
Kent DoiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1138655, Japan.

Funding

Ministry of Health, Labour and Welfare 24AA2006
6 · The paper itself

Abstract

backgroundCorticosteroids improve the outcomes of severe pneumonia; however, the most effective type remains unknown. In this study, we compared the mortality rates of patients with severe pneumonia who were treated with methylprednisolone versus those treated with hydrocortisone.

methodsIn this retrospective observational study, we utilized a nationwide Japanese Diagnosis Procedure Combination inpatient database to include adult patients with severe pneumonia who were admitted to hospitals between April 2017 and March 2022 and received either methylprednisolone or hydrocortisone. Propensity score matching was used to adjust for measured confounders, with in-hospital mortality as the primary outcome.

resultsAmong the 5,084 eligible patients, 623 matched pairs were analyzed. In-hospital mortality rates were 23.9% in the hydrocortisone group and 19.4% in the methylprednisolone group (risk difference [RD], 4.5%; 95% confidence interval [CI] -0.082 to 9.1; p = 0.054). Subgroup analysis of patients with shock demonstrated significantly higher mortality in the hydrocortisone group than in the methylprednisolone group (44.7% versus 30.1%; RD, 14.6%; 95% CI 1.4-27.8; p = 0.031).

conclusionNo significant difference in in-hospital mortality was observed between patients with severe pneumonia treated with methylprednisolone and those treated with hydrocortisone. Nevertheless, patients experiencing severe pneumonia-induced septic shock may derive benefits from methylprednisolone treatment.

Indexed as

CorticosteroidIn-hospital mortalityPropensity score matchingSeptic shockSevere pneumonia

Identifiers

PMID40665428
PMCPMC12261853

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