A55-28 Corticosteroid Therapy in ICU Patients With Aspiration Pneumonitis: Patterns, Outcomes, and Subgroup Analysis

Purpose The objective of this study is to evaluate whether corticosteroid administration is associated with improved clinical outcomes in ICU patients diagnosed with aspiration pneumonitis. Specifically, we aim to:1.Determine the prevalence and patterns of corticosteroid use in this population2.Assess the association between corticosteroid therapy and respiratory support, need for mechanical ventilation, ICU length of stay, and in-hospital mortality3.Explore the current evidence regarding the use of steroid usage with patients who have acute aspiration events with an effort to evaluate the outcomes of a broad population of ICU patients to determine if there is a subgroup of patients who would benefit from steroid therapy. Methods We conducted a retrospective cohort study of adult ICU patients diagnosed with aspiration pneumonitis, specifically those coded with ICD-10 J69 (aspiration pneumonitis) and J96 (acute respiratory failure). Key variables will include patient demographics such as age at ICU admission, gender, and the Charlson comorbidity index, as well as clinical metrics like APACHE III and OASIS severity scores, average and maximum fraction of inspired oxygen (FiO2) during the first 48 hours, maximum oxygen delivery flow rate, and details regarding mechanical ventilation. Patients were then stratified into subgroups for further chi squared analysis for evaluation of steroid use with mortality. Results After stratifying for APS III and Charlson index both supplemental O2 and mechanically ventilated patients did not show significant differences in mortality either with or without the use of steroids. However, there seems to be a non-significant trend towards worse mortality outcomes in steroid administration. Conclusion This study does not show an association with the use of corticosteroid therapy in patients with aspiration pneumonitis on mortality. Further research is needed to clarify whether specific patient subgroups, such as those requiring mechanical ventilation or early intervention, derive benefit from corticosteroid administration. Further studies addressing the causal relationship and confounders would be needed. Clinical Implications Given the implications for the use of corticosteroids, this study explored how its use impacted mortality after stratifying for various key factors. It is not directly conclusive from this study whether or not the steroids are harmful or beneficial. More studies would be needed to further evaluate this.