Do We Need to Administer Fludrocortisone in Addition to Hydrocortisone in Adult Patients With Septic Shock? An Updated Systematic Review With Bayesian Network Meta-Analysis of Randomized Controlled Trials and an Observational Study With Target Trial Emulation*
Pooled result · Short-term mortalityResult — go to the resultOdds ratio 0.79 95% CrI 0.64–0.99Authors' conclusion
In adults with septic shock, hydrocortisone plus fludrocortisone improved short-term survival with minimal adverse events compared with hydrocortisone alone or placebo.
Study context
- Population
- Adults with septic shock
- Participants
- 95,841 adults · 19 studies
- Comparison
- Hydrocortisone plus fludrocortisone or hydrocortisone alone vs placebo
- Outcome
- Short-term mortality (28- or 30-day; in-hospital or ICU mortality as nearest surrogate)
Methodological detailsinformative priors, update of a prior Cochrane review, Databases searched until August 31, 2023
- Informative priors
- Update of a prior Cochrane review
- Databases searched until August 31, 2023
Pooled result
Short-term mortality
Odds ratio
0.79
95% CrI 0.64–0.99
By group
Hydrocortisone plus fludrocortisone
0.9469
SUCRA
Hydrocortisone alone
0.4542
SUCRA
Placebo
0.0989
SUCRA
Hydrocortisone plus fludrocortisone vs Placebo
OR 0.79 (95% CrI 0.64–0.99)
As reported in the abstract
Further pooled results
Short-term mortality, RCTs alone and daily 200-mg hydrocortisone (sensitivity analyses)
- Consistent results
Safety
| Outcome | OR |
|---|---|
| HyperglycemiaPlacebo vs Hydrocortisone plus fludrocortisone · very low certainty of evidence | 0.53 |
| HyperglycemiaPlacebo vs Hydrocortisone alone · very low certainty of evidence | 0.64 |
Gastroduodenal bleeding, superinfection
- No clear increase
Hyperglycemia
- Hyperglycemia risk increased
Original publication
Do We Need to Administer Fludrocortisone in Addition to Hydrocortisone in Adult Patients With Septic Shock? An Updated Systematic Review With Bayesian Network Meta-Analysis of Randomized Controlled Trials and an Observational Study With Target Trial Emulation*. Crit Care Med. Published 29 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →