Impact of the duration of corticosteroid treatment for postoperative acute lung injury following lung cancer surgery.

IF 2.1 3区医学 Q3 RESPIRATORY SYSTEM

Journal of thoracic disease Pub Date : 2025-01-24 Epub Date: 2025-01-22 DOI:10.21037/jtd-24-1295

Sungmin Zo, Junghee Lee, Yeong Jeong Jeon, Hong Kwan Kim, Kyeongman Jeon

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引用次数: 0

Abstract

Background: Acute lung injury (ALI) is one of the most serious pulmonary complications following lung resection. Despite the known beneficial effects of corticosteroid treatment for postoperative ALI, limited data are available regarding corticosteroid treatment duration. This study aimed to evaluate the beneficial effects of a short-course corticosteroid in patients with postoperative ALI following lung resection surgery for lung cancer.

Methods: This retrospective observational study included 91 patients who were treated with corticosteroids for postoperative ALI among 7,317 patients who underwent lung resection surgery for lung cancer between January 2017 and March 2021. Patients were divided into two groups, short (≤14 days, n=31) and long (≥15 days, n=60) courses, on the basis of corticosteroid treatment duration.

Results: While similar baseline characteristics were observed between the two groups, the short-course group had a higher corticosteroid loading dose than the long-course group; however, the cumulative dose in the first 7 days was not different between the two groups. Overall, in-hospital mortality rates were 3.2% and 26.7% in the short- and long-course groups, respectively (P=0.01). Moreover, the long-course group had higher additional intensive care unit (ICU) admission (32.3% vs. 60.0%, P=0.02) and persistent air leakage (0% vs. 13.3%, P=0.09). In the logistic regression analysis, corticosteroid treatment duration was marginally associated with in-hospital mortality [adjusted odds ratio (OR), 9.03; 95% confidence interval (CI): 0.96-84.9, P=0.054].

Conclusions: Short-course corticosteroid treatment was associated with a lower rate of surgical site complications, additional ICU admission, and in-hospital mortality, which suggests the necessity of efforts for reducing the total duration by weighing the benefits and adverse effects of corticosteroid treatment for postoperative ALI.

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来源期刊

Journal of thoracic disease RESPIRATORY SYSTEM-

CiteScore

4.60

自引率

4.00%

发文量

254

期刊介绍： The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.