Rapid uptake of adjunctive corticosteroids for critically ill adults with septic shock following publication of ADRENAL trial. A multicenter, retrospective analysis of prescribing practices in Queensland Intensive Care Units
Authors' conclusion
Publication of the ADRENAL trial changed clinical practice in Queensland ICUs with increased prescription of hydrocortisone for patients with septic shock with an associated reduction in mortality.
Study context
- Population
- Critically ill adults with septic shock in 12 Queensland intensive care units (ICUs)
- Participants
- 4,198 adults · 12 ICUs
- Exposure
- Pre-publication vs Transition vs Post-publication periods
- Outcome
- Hydrocortisone administration and 90-day mortality associated with publication of the ADRENAL trial
Methodological detailsmulticentre, segmented linear regression
- Multicentre
- Segmented linear regression
Main finding
As reported in the abstract
Hydrocortisone administration
Each group vs pre-publicationOdds ratio (95% CI)P value
Transition
1.4(1.14–1.77)
P = 0.0015Post-publication
2.03(1.74–2.36)
P < 0.001- Overall difference in proportions across periods
- P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value |
|---|---|---|
| 90-day mortality, hydrocortisone use (adjusted for confounders) · 14% vs. 24% absolute difference | −0.81 (0.65–0.99) | P = 0.044 |
Slope of proportion receiving hydrocortisone (adjusted for temporal change)
- Transition period slope change (−0.1% per month vs. +1.4% per month)
- P = 0.026
- Post-publication period slope, not statistically significant (+0.1% per month)
- P = 0.66
Original publication
Rapid uptake of adjunctive corticosteroids for critically ill adults with septic shock following publication of ADRENAL trial. A multicenter, retrospective analysis of prescribing practices in Queensland Intensive Care Units. Anaesth Crit Care Pain Med. Published 5 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →