Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
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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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. |
publishDate |
2022 |
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2022 |
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2023-11-18T03:27:04Z |
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0104-4230 |
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001186279 |
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eng |
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Revista da Associação Médica Brasileira. São Paulo. Vol. 68, n. 9 (2022), p. 1199–1203 |
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