Study Sample
As part of this retrospective cohort study, we identified encounters in which patients with CF were hospitalized from 6/1/2013 through 8/31/2017 at Doernbecher Children’s Hospital. Of the 822 CF patient admissions during our study period, corticosteroids were ordered in 188 encounters and 122 of those met the following inclusion criteria:  patient age of 6-20 years; patient able to perform spirometry; and, admission duration of at least 12 days (Figure 1). We additionally excluded encounters if the following were true: missing FEV1pp data at baseline, admission, midpoint or discharge, steroids were ordered by care teams other than pulmonary, such as for otolaryngology procedures; steroids were ordered upon admission; patient history of adrenal insufficiency or chronic oral steroid use; patient diagnosis of CF related diabetes; FEV1pp less than 40% at baseline; patient with CPAP/BiPAP requirement; and, patient history of ABPA or lung transplant. Prior to data abstraction, we selected non-steroid treated, comparison encounters that were similar in date, age, and gender to the steroid encounters; these comparison encounters were selected blindly from CF encounters that would have otherwise met our inclusion/exclusion criteria. Our final study sample consisted of 106 encounters, with 53 unique patients; 63 encounters included corticosteroid use and 43 were matched non-steroid encounters. This study was approved by the Oregon Health and Science University Institutional Review Board (IRB#16866).