What is the most significant risk factor for patients receiving corticosteroid therapy?

The most significant risk factor for patients receiving corticosteroid therapy is the increased risk of infection. Corticosteroids are powerful anti-inflammatory medications that also suppress the immune system's ability to respond to pathogens. This immune suppression can predispose patients to infections, both opportunistic and common bacterial infections.

When corticosteroid therapy is administered, especially at high doses or over an extended period, the body’s defense mechanisms weaken. This can lead to an inability to effectively fight off infections that a healthy immune system would typically manage. Patients may not only be more susceptible to infections but might also present atypical signs of infections, making early detection and management more challenging.

In contrast, while fluid retention, increased caloric demand, and gastrointestinal bleeding are indeed concerns associated with corticosteroid use, they do not carry the same level of risk for immediate and potentially severe outcomes as infections do. The ramifications of infection in patients whose immune response is compromised can lead to complications that may be critical, thereby underscoring the importance of monitoring for this risk while managing patients on corticosteroids.