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Steroid pulse therapy for severe fever with thrombocytopenia syndrome patients may not improve prognosis: Retrospective analysis with overlap weighting using a national inpatient database

医学 严重发热伴血小板减少综合征 内科学 联合疗法 回顾性队列研究 病毒 免疫学
作者
Satoshi Kutsuna,Hiroyuki Ohbe,Hiroki Matsui,Hideo Yasunaga
出处
期刊:Journal of Infection and Chemotherapy [Elsevier BV]
卷期号:29 (5): 490-494 被引量:2
标识
DOI:10.1016/j.jiac.2023.01.022
摘要

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus. Effective treatment for SFTS has not been established, but steroid pulse therapy is often used. This study aimed to verify whether steroid pulse therapy for SFTS improves prognosis or not.Data of SFTS patients were obtained from the Japanese Diagnosis Procedure Combination Database from April 2013 to March 2021. Patients treated with steroid pulse therapy were compared with untreated patients, using overlap weighting and traditional multivariable regression analysis to evaluate the impact of steroid pulse therapy on prognosis.412 SFTS patients were included in this study, and 66 (16%) underwent steroid pulse therapy within 3 days of admission and were allocated to the steroid pulse therapy group. After overlap weighting, patients in the steroid pulse therapy group had a significantly higher in-hospital mortality rate than patients in the control group (31.1% vs. 20.5%; difference: +10.6%; 95% confidence interval: +2.2% to +19.0%). There were no statistically significant differences in hospitalization cost and length of hospital stay between the two groups. The results of the sensitivity analysis using traditional multivariable regression were similar to those of the main analysis.In the analysis of SFTS patients using the Japanese Diagnosis Procedure Combination inpatient data, steroid pulse therapy did not improve patient prognosis. The evidence does not support the universal use of steroid pulse therapy in patients with severe SFTS.
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