Systemic corticosteroids and mortality in acute infectious encephalitis
Abstract
OBJECTIVE
To evaluate the association between systemic corticosteroids and mortality in patients with acute infectious encephalitis.
METHODS
We performed a retrospective cohort study in patients with preliminary diagnosed as acute infectious encephalitis admitted in Khon Kaen Hospital, Thailand. We identified the patients through the hospital database using the international classification of disease, 10th revision (ICD-10) matching the disease. We divided the patients into two groups; with systemic corticosteroids administration and without administration. The primary outcome was death.
RESULTS
From January 2011 through May 2017, a total of 533 patients was included; 158 received systemic corticosteroid, 375 did not. The mortality rate was significantly higher in the group with the systemic corticosteroid administration group than that without (relative rate [RR], 1.34; 95% confidence interval [CI], 1.08 to 1.66). The former group also had poorer outcomes; cardiac arrest (RR 1.68; 95% CI, 1.13 to 2.50), on mechanical ventilation (RR 1.44; 95% CI, 1.26 to 1.65). From the former analysis, the factors that found to be associated with death within 30 days after admission included being male (AOR, 0.38; 95% CI, 0.17 to 0.87) and open pressure (AOR, 1.04; 95% CI,1.002 to 1.09). However, from the Cox proportional hazard regression, the factors that found to be associated with 30 days mortality after admission included age (AHR, 1.02; 95% CI, 1.01 to 1.026) and GCS score at admission (AHR, 0.88; 95% CI, 0.84 to 0.91).
CONCLUSION
The systemic corticosteroids had no statistically significant benefit on the mortality rate in acute infectious encephalitis.
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