{"id":"https://openalex.org/W7225429767","doi":"https://doi.org/10.1186/s12890-026-04809-8","title":"Early intravenous corticosteroid and 28-day mortality in critically ill adults with an ICD-coded aspiration syndrome: a retrospective MIMIC-IV cohort study","display_name":"Early intravenous corticosteroid and 28-day mortality in critically ill adults with an ICD-coded aspiration syndrome: a retrospective MIMIC-IV cohort study","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225429767","doi":"https://doi.org/10.1186/s12890-026-04809-8"},"language":"en","primary_location":{"id":"doi:10.1186/s12890-026-04809-8","doi":"https://doi.org/10.1186/s12890-026-04809-8","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12890-026-04809-8","pdf_url":null,"source":{"id":"https://openalex.org/S204956882","display_name":"BMC Pulmonary Medicine","issn_l":"1471-2466","issn":["1471-2466"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Pulmonary Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12890-026-04809-8","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161119001","display_name":"Weiqi Li","orcid":"https://orcid.org/0009-0000-2540-9791","observed_orcids":["https://orcid.org/0009-0000-2540-9791"]},"institutions":[{"id":"https://openalex.org/I157773358","display_name":"Sun Yat-sen University","ror":"https://ror.org/0064kty71","country_code":"CN","type":"education","lineage":["https://openalex.org/I157773358"]},{"id":"https://openalex.org/I4210097354","display_name":"Sun Yat-sen Memorial Hospital","ror":"https://ror.org/01px77p81","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210097354"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Weiqi Li","raw_affiliation_strings":["Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China"],"raw_orcid":"https://orcid.org/0009-0000-2540-9791","affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China","institution_ids":["https://openalex.org/I157773358","https://openalex.org/I4210097354"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161062142","display_name":"Linlin Lv","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I157773358","display_name":"Sun Yat-sen University","ror":"https://ror.org/0064kty71","country_code":"CN","type":"education","lineage":["https://openalex.org/I157773358"]},{"id":"https://openalex.org/I4210097354","display_name":"Sun Yat-sen Memorial Hospital","ror":"https://ror.org/01px77p81","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210097354"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Linlin Lv","raw_affiliation_strings":["Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China","institution_ids":["https://openalex.org/I157773358","https://openalex.org/I4210097354"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5100600414","display_name":"Fangyi Li","orcid":"https://orcid.org/0009-0007-6009-8117","observed_orcids":["https://orcid.org/0009-0007-6009-8117"]},"institutions":[{"id":"https://openalex.org/I157773358","display_name":"Sun Yat-sen University","ror":"https://ror.org/0064kty71","country_code":"CN","type":"education","lineage":["https://openalex.org/I157773358"]},{"id":"https://openalex.org/I4210097354","display_name":"Sun Yat-sen Memorial Hospital","ror":"https://ror.org/01px77p81","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210097354"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Fangyi Li","raw_affiliation_strings":["Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China","institution_ids":["https://openalex.org/I157773358","https://openalex.org/I4210097354"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5100600414"],"corresponding_institution_ids":["https://openalex.org/I157773358","https://openalex.org/I4210097354"],"apc_list":{"value":3090,"currency":"USD","value_usd":3090},"apc_paid":{"value":3090,"currency":"USD","value_usd":3090},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11681","display_name":"Nosocomial Infections in ICU","score":0.3082999885082245,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11681","display_name":"Nosocomial Infections in ICU","score":0.3082999885082245,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10322","display_name":"Respiratory Support and Mechanisms","score":0.20080000162124634,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10218","display_name":"Sepsis Diagnosis and Treatment","score":0.14429999887943268,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/aspiration-syndrome","display_name":"aspiration syndrome","score":0.6919999718666077},{"id":"https://openalex.org/keywords/intravenous-corticosteroids","display_name":"intravenous corticosteroids","score":0.8970000147819519},{"id":"https://openalex.org/keywords/systemic-corticosteroid-therapy","display_name":"systemic corticosteroid therapy","score":0.8939999938011169},{"id":"https://openalex.org/keywords/28-day-mortality","display_name":"28-day mortality","score":0.9449999928474426},{"id":"https://openalex.org/keywords/critically-ill-adults","display_name":"critically ill adults","score":0.9160000085830688},{"id":"https://openalex.org/keywords/intensive-care-unit","display_name":"intensive care unit","score":0.5690000057220459},{"id":"https://openalex.org/keywords/chemical-pneumonitis","display_name":"chemical pneumonitis","score":0.6869999766349792},{"id":"https://openalex.org/keywords/bacterial-pneumonia","display_name":"bacterial pneumonia","score":0.6460000276565552},{"id":"https://openalex.org/keywords/icu-free-days","display_name":"ICU-free days","score":0.6389999985694885},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.4740000069141388},{"id":"https://openalex.org/keywords/propensity-score-matching","display_name":"propensity score matching","score":0.4410000145435333},{"id":"https://openalex.org/keywords/mimic-iv","display_name":"MIMIC-IV","score":0.7049999833106995}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9544000029563904},{"id":"https://openalex.org/C2776804153","wikidata":"https://www.wikidata.org/wiki/Q210420","display_name":"Corticosteroid","level":2,"score":0.6819999814033508},{"id":"https://openalex.org/C2776376669","wikidata":"https://www.wikidata.org/wiki/Q5094647","display_name":"Intensive care unit","level":2,"score":0.6032999753952026},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.5142999887466431},{"id":"https://openalex.org/C207103383","wikidata":"https://www.wikidata.org/wiki/Q3930246","display_name":"Hazard ratio","level":3,"score":0.4830000102519989},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.4580000042915344},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.4291999936103821},{"id":"https://openalex.org/C45827449","wikidata":"https://www.wikidata.org/wiki/Q5270338","display_name":"Diagnosis code","level":3,"score":0.4235000014305115},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.4219000041484833},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3919999897480011},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.3919000029563904},{"id":"https://openalex.org/C44315111","wikidata":"https://www.wikidata.org/wiki/Q1344580","display_name":"Enteral administration","level":3,"score":0.38670000433921814},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.38670000433921814},{"id":"https://openalex.org/C2778720950","wikidata":"https://www.wikidata.org/wiki/Q424972","display_name":"Prednisone","level":2,"score":0.3853999972343445},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.37059998512268066},{"id":"https://openalex.org/C179755657","wikidata":"https://www.wikidata.org/wiki/Q58702","display_name":"Mortality rate","level":2,"score":0.3544999957084656},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.35100001096725464},{"id":"https://openalex.org/C2780558435","wikidata":"https://www.wikidata.org/wiki/Q3491700","display_name":"Fungemia","level":3,"score":0.3391000032424927},{"id":"https://openalex.org/C10515644","wikidata":"https://www.wikidata.org/wiki/Q543310","display_name":"Survival analysis","level":2,"score":0.31700000166893005},{"id":"https://openalex.org/C2991859549","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Critically ill","level":2,"score":0.31049999594688416},{"id":"https://openalex.org/C2778129406","wikidata":"https://www.wikidata.org/wiki/Q2507454","display_name":"Adrenal insufficiency","level":2,"score":0.3091000020503998},{"id":"https://openalex.org/C2780252810","wikidata":"https://www.wikidata.org/wiki/Q1455316","display_name":"Immunosuppression","level":2,"score":0.30550000071525574},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.3043000102043152},{"id":"https://openalex.org/C2776888751","wikidata":"https://www.wikidata.org/wiki/Q767485","display_name":"Respiratory failure","level":2,"score":0.2957000136375427},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2694999873638153},{"id":"https://openalex.org/C2777080012","wikidata":"https://www.wikidata.org/wiki/Q3766250","display_name":"Mechanical ventilation","level":2,"score":0.26350000500679016},{"id":"https://openalex.org/C2776283816","wikidata":"https://www.wikidata.org/wiki/Q332823","display_name":"Survival rate","level":2,"score":0.2535000145435333}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12890-026-04809-8","doi":"https://doi.org/10.1186/s12890-026-04809-8","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12890-026-04809-8","pdf_url":null,"source":{"id":"https://openalex.org/S204956882","display_name":"BMC Pulmonary Medicine","issn_l":"1471-2466","issn":["1471-2466"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Pulmonary Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12890-026-04809-8","doi":"https://doi.org/10.1186/s12890-026-04809-8","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12890-026-04809-8","pdf_url":null,"source":{"id":"https://openalex.org/S204956882","display_name":"BMC Pulmonary Medicine","issn_l":"1471-2466","issn":["1471-2466"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Pulmonary Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7161544816","https://openalex.org/W2268806802","https://openalex.org/W2029434629","https://openalex.org/W2036981384","https://openalex.org/W7140298450","https://openalex.org/W7225048376","https://openalex.org/W2756589534","https://openalex.org/W7130692586","https://openalex.org/W3169763678","https://openalex.org/W3010286780"],"abstract_inverted_index":{"Systemic":[0],"corticosteroid":[1,36,140,184,195,205,255,291],"therapy":[2],"is":[3],"not":[4,329],"established":[5],"for":[6,49,165],"aspiration-related":[7],"respiratory":[8],"illness.":[9],"Because":[10],"ICD-9":[11],"code":[12,16,70,76],"507.0":[13,71],"and":[14,38,56,110,126,177,197,273,311,317,327],"ICD-10":[15],"J69.0":[17,77],"capture":[18],"a":[19,136,210,307],"heterogeneous":[20],"syndrome":[21],"that":[22],"may":[23],"include":[24],"chemical":[25],"pneumonitis,":[26],"bacterial":[27],"pneumonia,":[28],"or":[29,72,101,181],"overlapping":[30],"processes,":[31],"the":[32,86,106,150,216,300,312],"association":[33],"between":[34],"early":[35,193,289],"treatment":[37],"clinical":[39],"outcomes":[40],"remains":[41],"uncertain.":[42],"We":[43],"analyzed":[44],"linked":[45],"Medical":[46],"Information":[47],"Mart":[48],"Intensive":[50],"Care":[51],"IV":[52],"(MIMIC-IV)":[53],"version":[54,58],"3.1":[55],"MIMIC-IV-Note":[57],"2.2":[59],"data.":[60],"Adults":[61],"with":[62,98,209,260,295],"International":[63],"Classification":[64],"of":[65,314],"Diseases,":[66],"Ninth":[67],"Revision":[68,74],"(ICD-9)":[69],"Tenth":[73],"(ICD-10)":[75],"were":[78,117],"eligible.":[79],"The":[80,119,133,153,161,232,242],"operational":[81],"index":[82],"time":[83,95],"(t0)":[84],"was":[85,96,122,135,156,207,236,248,257,293],"earliest":[87],"high-confidence":[88],"radiology-note":[89],"timestamp":[90],"when":[91],"available;":[92],"otherwise,":[93],"admission":[94],"used":[97],"discharge-note":[99],"support":[100],"ICD":[102],"evidence":[103],"alone.":[104],"Only":[105],"first":[107,111],"eligible":[108],"hospitalization":[109],"intensive":[112],"care":[113],"unit":[114],"(ICU)":[115],"stay":[116],"retained.":[118],"primary":[120,154,217,301],"analysis":[121],"conditional":[123],"on":[124],"survival":[125],"observability":[127],"through":[128,158,245],"t0":[129],"plus":[130],"24":[131],"h.":[132],"exposure":[134],"prescription-recorded":[137],"intravenous":[138,194,204,254,290],"systemic":[139,183],"order":[141,196],"starting":[142],"within":[143],"this":[144,285],"24-hour":[145,151],"window.":[146],"Follow-up":[147],"began":[148],"at":[149],"landmark.":[152],"outcome":[155],"death":[157],"day":[159,201,246],"28.":[160,202],"Cox":[162],"model":[163,219],"adjusted":[164,212,243],"demographics,":[166],"Acute":[167],"Physiology":[168],"Score":[169],"III":[170],"(APS":[171],"III),":[172],"major":[173],"comorbidities,":[174],"immunosuppression":[175],"history,":[176],"recorded":[178],"pre-t0":[179],"oral":[180],"enteral":[182],"exposure.":[185],"Among":[186],"5,270":[187],"patients,":[188],"413":[189],"(7.8%)":[190],"had":[191],"an":[192],"1,426":[198],"died":[199],"by":[200],"Early":[203,253],"ordering":[206,256,292],"associated":[208,259,294],"higher":[211,296],"mortality":[213,298],"hazard":[214],"in":[215,299,306],"landmark":[218,233,302],"(hazard":[220],"ratio":[221],"[HR],":[222],"1.40;":[223],"95%":[224,268,279],"confidence":[225],"interval":[226],"[CI],":[227],"1.18\u20131.66;":[228],"p":[229],"<":[230],"0.001).":[231],"propensity-score-matched":[234],"estimate":[235],"HR":[237,244],"1.45":[238],"(95%":[239,250],"CI,":[240,251,269,280],"1.15\u20131.84).":[241],"90":[247],"1.29":[249],"1.11\u20131.49).":[252],"also":[258],"fewer":[261],"index-ICU-free":[262],"days":[263,275],"(adjusted":[264],"mean":[265],"difference,":[266],"\u22121.38;":[267],"\u22122.45":[270],"to":[271,282],"\u22120.31)":[272],"hospital-free":[274],"(":[276],"\u2212":[277],"1.20;":[278],"\u22122.06":[281],"\u22120.33).":[283],"In":[284],"ICD-coded":[286],"aspiration-syndrome":[287],"cohort,":[288],"short-term":[297],"analysis.":[303],"Material":[304],"attenuation":[305],"stricter":[308],"index-time":[309],"restriction":[310],"possibility":[313],"phenotype,":[315],"timing,":[316],"indication":[318],"bias":[319],"limit":[320],"causal":[321],"interpretation.":[322],"These":[323],"findings":[324],"are":[325],"hypothesis-generating":[326],"do":[328],"establish":[330],"harm":[331],"from":[332],"corticosteroids.":[333],"Not":[334],"applicable.":[335]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-11-07T00:00:00"}
