The Timing of Initiating Hydrocortisone and Long-term Mortality in Septic Shock
Main findingResult — go to the resultAdjusted hazard ratio 1.39 95% CI 1.13–1.71Authors' conclusion
In patients with septic shock, initiating hydrocortisone >12 hours after vasopressor use was associated with an increased risk of both short-term and long-term mortality, and a prolonged length of hospital stay.
Study context
- Population
- Adults with septic shock (Sepsis-3) who received hydrocortisone, MIMIC-IV intensive care unit (ICU) database
- Participants
- 844 adults
- Exposure
- Late vs early hydrocortisone initiation after vasopressor use
- Laten = 291
- Earlyn = 553reference
- Outcome
- 1-year mortality
- Follow-up
- 1 year
Methodological detailsadministrative database (MIMIC-IV), multivariable Cox proportional hazard analysis
- Administrative database (MIMIC-IV)
- Multivariable Cox proportional hazard analysis
Main finding
As reported in the abstract
Adjusted hazard ratio
1.39
95% CI 1.13–1.71
P = 0.002
Late vs Early
aHR 1.39 (95% CI 1.13–1.71); P = 0.002
Observational data: associations, not effects.
Secondary outcomes
28-day, 90-day and in-hospital mortality, LOS in hospital
- Late initiation also associated with increased 28-day, 90-day and in-hospital mortality and prolonged hospital LOS
Time to hydrocortisone initiation
- Median time to hydrocortisone initiation (IQR 2.0-19.0 hours)
- 7 hours
Original publication
The Timing of Initiating Hydrocortisone and Long-term Mortality in Septic Shock. Anesth Analg. Published 12 May 2023. doi:10.
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