METHODS: Data were retrospectively collected from the Japanese Diagnosis Procedure Combination database from July 2010 to March 2018. Adult patients with AE-IIPs who received high-dose (methylprednisolone at a dose of 500-1000 mg/day for 3 days starting within 4 days after admission) or low-dose (methylprednisolone at a dose of 100-200 mg/day for at least 5 days starting within 4 days after admission) corticosteroid therapy were identified. Eligible patients (n = 17,317) were divided into the high-dose (n = 16,998) and low-dose (n = 319) groups. A stabilized inverse probability of treatment weighting using propensity scores was performed to compare outcomes between the groups.
RESULTS: The primary outcome was in-hospital mortality, and the secondary outcomes were 28-day mortality, infections during hospitalization, length of hospitalization, duration of steroid use, and discharge to home. The in-hospital mortality rates of the high- and low-dose corticosteroid groups were 50.6% and 47.0%, respectively. In-hospital mortality did not significantly differ between the two groups after stabilized inverse probability of treatment weighting, and the odds ratio in the low-dose corticosteroid group was 0.86 (95% confidence interval: 0.64-1.16; p = 0.33). The secondary outcomes also did not significantly differ between the groups.
CONCLUSIONS: There was no significant difference in outcomes between patients with AE-IIPs who received high- and low-dose corticosteroid therapies.
方法:数据回顾性收集自2010年7月至2018年3月的日本诊断程序组合数据库。确定了接受高剂量(甲基强的松龙500-1000mg/天,从入院后4天内开始3天)或低剂量(甲基强的松龙100-200mg/天,从入院后4天内开始至少5天)皮质类固醇治疗的AE-IIP成年患者。符合条件的患者(n=17,317)被分为高剂量组(n=16,998)和低剂量组(n=319)。使用倾向评分进行稳定的治疗加权逆概率以比较组间的结果。
结果:主要结局是住院死亡率,次要结局是28天死亡率,住院期间感染,住院时间,类固醇使用的持续时间,出院回家。高、低剂量糖皮质激素组的住院死亡率分别为50.6%和47.0%,分别。在稳定的治疗权重逆概率后,两组的住院死亡率没有显着差异。低剂量皮质类固醇组的比值比为0.86(95%置信区间:0.64-1.16;p=0.33)。两组之间的次要结果也没有显着差异。
结论:接受高剂量和低剂量皮质类固醇治疗的AE-IIP患者的预后没有显著差异。