| アブストラクト | OBJECTIVES: A mortality rate of non-human immunodeficiency virus-infected pneumocystis pneumonia (non-HIV PCP) is 30-60%. But the effectiveness of adjunctive corticosteroids with trimethoprim-sulfamethoxazole has been unclear, and we examined whether it lowered risk of mortality in non-HIV PCP. METHODS: We did an observational study of adult non-HIV PCP patients from April 2010 through March 2016, using Japanese nationwide healthcare records of the Diagnostic Procedure Combination database (DPC). The risk was estimated by the time-dependent Cox regression analyses with inverse probability weights. RESULT: 1299 eligible non-HIV PCP patients were identified. 737 patients were severe respiratory status (partial pressure of oxygen in arterial blood [PaO2] </=60mm Hg) and 562 were moderate (PaO2 >60mm Hg) at hospital admission. Among patients with severe respiratory status, the adjunctive corticosteroids was associated with lower risk of 60-day mortality (HR 0.71; 95% confidence interval [CI], 0.55-0.91), and significantly decreased mortality rates (24.7% vs 36.6%, P=0.006). In contrast, no significant differences were observed in the risk of 60-day mortality (HR 1.17; 95% CI, 0.73-1.86) and the mortality rate (10.9% vs 9.1%, P=0.516) among patients with moderate respiratory status. CONCLUSION: The adjunctive corticosteroids were associated with lower risk of 60-day mortality in severe non-HIV PCP patients. |
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| 組織名 | Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School, S1560/S1568 M&D Tower, 1-5-45 Yushima, Bunkyo-Ku, Tokyo;113-8519, Japan; Department of Clinical Data Management and Research, Clinical;Research Center, National Hospital Organization Headquarters, 2-5-21,;Higashigaoka, Meguro-Ku, 152-8621, Tokyo, Japan; Department of Information;Technology and Management, National Center for Child Health and Development,;2-10-1 Okura, Setagaya-Ku, 157-8535, Tokyo, Japan.;Higashigaoka, Meguro-Ku, 152-8621, Tokyo, Japan. Electronic address:;kfushimi.hci@tmd.ac.jp. |
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