Corticosteroid Use in the Intensive Care Unit: At What Cost?

HYPOTHESIS Corticosteroid use has a significant effect on morbidity and mortality in the intensive care unit (ICU). DESIGN Case-control study. SETTING Burn-trauma ICU in a level 1 trauma center. PATIENTS All patients who received corticosteroids while in the ICU from January 1, 2002, to December 31, 2003 (n = 100), matched by age and Injury Severity Score with a control group (n = 100). INTERVENTIONS None. MAIN OUTCOME MEASURES We considered the following 7 outcomes: pneumonia, bloodstream infection, urinary tract infection, other infections, ICU length of stay (LOS), ventilator LOS, and mortality. RESULTS Cases and controls had similar APACHE II (Acute Physiology and Chronic Health Evaluation II) scores and medical history. In univariate analysis, the corticosteroid group had a significant increase in pneumonia (26% vs 12%; P