Prognostic impact of early adjunctive corticosteroid therapy in non-HIV oncology or haematology patients with Pneumocystis jirovecii pneumonia: A propensity score analysis
| العنوان: | Prognostic impact of early adjunctive corticosteroid therapy in non-HIV oncology or haematology patients with Pneumocystis jirovecii pneumonia: A propensity score analysis |
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| المؤلفون: | Frédéric Gonzalez, Laurent Chow-Chine, Magali Bisbal, Luca Servan, Jérôme Lambert, Antoine Sannini, Norbert Vey, Mehdi Assal, Marion Faucher, Djamel Mokart, Jean Manuel de Guibert |
| المصدر: | PLoS ONE PLoS ONE, Vol 16, Iss 4, p e0250611 (2021) |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Oncology, Male, Pulmonology, medicine.medical_treatment, Severity of Illness Index, Steroid Therapy, Hematologic Cancers and Related Disorders, Medical Conditions, Adrenal Cortex Hormones, Medicine and Health Sciences, Intubation, Multidisciplinary, Hematology, Pharmaceutics, Mortality rate, Pneumonia, Pneumocystis, Fungal Diseases, Middle Aged, Prognosis, Survival Rate, Treatment Outcome, Infectious Diseases, Hematologic Neoplasms, Medicine, Female, Research Article, medicine.medical_specialty, Death Rates, Science, Corticosteroid Therapy, Surgical and Invasive Medical Procedures, Drug Therapy, Population Metrics, Internal medicine, medicine, Humans, Transplantation, Homologous, Propensity Score, Aged, Proportional Hazards Models, Retrospective Studies, Population Biology, business.industry, Pneumocystis, Cancer, Biology and Life Sciences, Cancers and Neoplasms, Retrospective cohort study, Pneumonia, medicine.disease, Transplantation, Co-Infections, Propensity score matching, business, Tomography, X-Ray Computed, Stem Cell Transplantation |
| الوصف: | Purpose While early adjunctive corticosteroid therapy (EACST) has been proven effective in HIV patients with Pneumocystis Jirovecii Pneumonia (PJP), data remains controversial concerning non-HIV oncology or haematology patients. Methods This retrospective study included cancer patients without HIV and with diagnosis of PJP admitted in a cancer referral centre, from January-1-2010 to March-31-2017. We compared 30-day and 1-year mortality rate, change in the respiratory item of the Sequential Organ Failure Assessment score(SOFA-resp worsening), use of tracheal intubation between day-1 and day-5 of anti-pneumocystis therapy and occurrence of coinfections between patients with EACST and those with no or late corticosteroid therapy, using an inverse probability weighting propensity score-based (IPW) analysis. Results 133 non-HIV oncology or haematology PJP patients were included (EACST n = 58, others n = 75). The main underlying conditions were haematological malignancies (n = 107, 80,5%), solid tumour (n = 27, 20,3%) and allogeneic stem cell transplantation (n = 17, 12,8%). Overall 30-day and 1-year mortality rate was 24,1% and 56,4%, respectively. IPW analysis found no difference on 30-day (HR = 1.45, 95% CI [0.7–3.04], p = 0.321) and 1-year (HR = 1.25, CI 95% [0.75–2.09], p = 0.39) mortality rate between groups. Conclusion No difference in SOFA-resp worsening, tracheal intubation and coinfections was found between groups. Combination of EACST with anti-pneumocystis therapy in non-HIV onco-haematology PJP-patients was not associated with clinical improvement. |
| تدمد: | 1932-6203 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::82a3dd1eaac21f5b921b5817beb185acTest https://pubmed.ncbi.nlm.nih.gov/33886692Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....82a3dd1eaac21f5b921b5817beb185ac |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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