Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis

Detalhes bibliográficos
Autor(a) principal: Lemos, Carolina Xavier
Data de Publicação: 2022
Outros Autores: Anton, Camila, Machado, Felipe Dominguez, Bernardi, Rafaela Manzoni, Freitas, Alana Ambos, Silva, Denise Rossato
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFRGS
Texto Completo: http://hdl.handle.net/10183/267292
Resumo: OBJECTIVES: In tuberculosis treatment, corticosteroids are used as adjuvants, especially in meningeal/pericardial tuberculosis. In other forms of the disease, especially in severe tuberculosis requiring mechanical ventilation, its use is controversial. The aim of the present study is to assess whether the use of corticosteroids in the treatment of pulmonary tuberculosis patients in mechanical ventilation is associated with in-hospital mortality. METHODS: This is a retrospective cohort study. Tuberculosis patients >18 years requiring mechanical ventilation, admitted to the emergency department or intensive care unit, were included. Data on corticosteroid use and mortality were collected. RESULTS: In total, 467 patients were included in the analysis; 399 used corticosteroids and 68 were noncorticosteroid users. The mortality rate was higher among corticosteroid users (59.9%) than in noncorticosteroid users (41.2%) (p=0.010). The total dose of corticosteroid in prednisone equivalents was not different between survivors and nonsurvivors (median [interquartile range]: 80 mg [5–56.6 mg] vs. 80 mg [50–135 mg]; p=0.881). CONCLUSIONS: Tuberculosis patients in mechanical ventilation who used corticosteroids had a higher mortality rate than those who did not use corticosteroids. The role of corticosteroids in pulmonary tuberculosis, especially in critically ill patients, remains unclear and needs further evaluation in prospective studies.
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spelling Lemos, Carolina XavierAnton, CamilaMachado, Felipe DominguezBernardi, Rafaela ManzoniFreitas, Alana AmbosSilva, Denise Rossato2023-11-18T03:27:04Z20220104-4230http://hdl.handle.net/10183/267292001186279OBJECTIVES: In tuberculosis treatment, corticosteroids are used as adjuvants, especially in meningeal/pericardial tuberculosis. In other forms of the disease, especially in severe tuberculosis requiring mechanical ventilation, its use is controversial. The aim of the present study is to assess whether the use of corticosteroids in the treatment of pulmonary tuberculosis patients in mechanical ventilation is associated with in-hospital mortality. METHODS: This is a retrospective cohort study. Tuberculosis patients >18 years requiring mechanical ventilation, admitted to the emergency department or intensive care unit, were included. Data on corticosteroid use and mortality were collected. RESULTS: In total, 467 patients were included in the analysis; 399 used corticosteroids and 68 were noncorticosteroid users. The mortality rate was higher among corticosteroid users (59.9%) than in noncorticosteroid users (41.2%) (p=0.010). The total dose of corticosteroid in prednisone equivalents was not different between survivors and nonsurvivors (median [interquartile range]: 80 mg [5–56.6 mg] vs. 80 mg [50–135 mg]; p=0.881). CONCLUSIONS: Tuberculosis patients in mechanical ventilation who used corticosteroids had a higher mortality rate than those who did not use corticosteroids. The role of corticosteroids in pulmonary tuberculosis, especially in critically ill patients, remains unclear and needs further evaluation in prospective studies.application/pdfengRevista da Associação Médica Brasileira. São Paulo. Vol. 68, n. 9 (2022), p. 1199–1203Tuberculose pulmonarRespiração artificialInsuficiência respiratóriaGlucocorticóidesCuidados críticosTuberculosisRespiration artificialRespiratory insufficiencyGlucocorticoidCritical careAdjunctive corticosteroid therapy in patients with pulmonary tuberculosisinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001186279.pdf.txt001186279.pdf.txtExtracted Texttext/plain20381http://www.lume.ufrgs.br/bitstream/10183/267292/2/001186279.pdf.txtc80284225bb62aee2f56bc0acd0b31d8MD52ORIGINAL001186279.pdfTexto completo (inglês)application/pdf185172http://www.lume.ufrgs.br/bitstream/10183/267292/1/001186279.pdf59eb2896ad068c621036d585f6ef89d4MD5110183/2672922023-11-19 04:21:50.260406oai:www.lume.ufrgs.br:10183/267292Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-11-19T06:21:50Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.pt_BR.fl_str_mv Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
title Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
spellingShingle Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
Lemos, Carolina Xavier
Tuberculose pulmonar
Respiração artificial
Insuficiência respiratória
Glucocorticóides
Cuidados críticos
Tuberculosis
Respiration artificial
Respiratory insufficiency
Glucocorticoid
Critical care
title_short Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
title_full Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
title_fullStr Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
title_full_unstemmed Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
title_sort Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
author Lemos, Carolina Xavier
author_facet Lemos, Carolina Xavier
Anton, Camila
Machado, Felipe Dominguez
Bernardi, Rafaela Manzoni
Freitas, Alana Ambos
Silva, Denise Rossato
author_role author
author2 Anton, Camila
Machado, Felipe Dominguez
Bernardi, Rafaela Manzoni
Freitas, Alana Ambos
Silva, Denise Rossato
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Lemos, Carolina Xavier
Anton, Camila
Machado, Felipe Dominguez
Bernardi, Rafaela Manzoni
Freitas, Alana Ambos
Silva, Denise Rossato
dc.subject.por.fl_str_mv Tuberculose pulmonar
Respiração artificial
Insuficiência respiratória
Glucocorticóides
Cuidados críticos
topic Tuberculose pulmonar
Respiração artificial
Insuficiência respiratória
Glucocorticóides
Cuidados críticos
Tuberculosis
Respiration artificial
Respiratory insufficiency
Glucocorticoid
Critical care
dc.subject.eng.fl_str_mv Tuberculosis
Respiration artificial
Respiratory insufficiency
Glucocorticoid
Critical care
description OBJECTIVES: In tuberculosis treatment, corticosteroids are used as adjuvants, especially in meningeal/pericardial tuberculosis. In other forms of the disease, especially in severe tuberculosis requiring mechanical ventilation, its use is controversial. The aim of the present study is to assess whether the use of corticosteroids in the treatment of pulmonary tuberculosis patients in mechanical ventilation is associated with in-hospital mortality. METHODS: This is a retrospective cohort study. Tuberculosis patients >18 years requiring mechanical ventilation, admitted to the emergency department or intensive care unit, were included. Data on corticosteroid use and mortality were collected. RESULTS: In total, 467 patients were included in the analysis; 399 used corticosteroids and 68 were noncorticosteroid users. The mortality rate was higher among corticosteroid users (59.9%) than in noncorticosteroid users (41.2%) (p=0.010). The total dose of corticosteroid in prednisone equivalents was not different between survivors and nonsurvivors (median [interquartile range]: 80 mg [5–56.6 mg] vs. 80 mg [50–135 mg]; p=0.881). CONCLUSIONS: Tuberculosis patients in mechanical ventilation who used corticosteroids had a higher mortality rate than those who did not use corticosteroids. The role of corticosteroids in pulmonary tuberculosis, especially in critically ill patients, remains unclear and needs further evaluation in prospective studies.
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dc.relation.ispartof.pt_BR.fl_str_mv Revista da Associação Médica Brasileira. São Paulo. Vol. 68, n. 9 (2022), p. 1199–1203
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