ArticleCritical care (London, England)2010
Global utilization of low-dose corticosteroids in severe sepsis and septic shock: a report from the PROGRESS registry.
Article in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.
- Effect of hydrocortisone-fludrocortisone combination on mortality in septic shock: a systematic review and meta-analysis.Infection · 2025Pooled it
- The cost-effectiveness of adjunctive corticosteroids for patients with septic shock.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2020Trial
- Clinical impact of stress dose steroids in patients with septic shock: insights from the PROWESS-Shock trial.Critical care (London, England) · 2015Trial
- Gluco- and mineralocorticoid biological effects of a 7-day treatment with low doses of hydrocortisone and fludrocortisone in septic shock.Intensive care medicine · 2012Trial
- Corticosteroid and antimicrobial therapy in macrolide-resistant pneumococcal pneumonia porcine model.Intensive care medicine experimental · 2025Article
- Intraoperative Low-Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study.Health science reports · 2025Article
- Personalized Piperacillin Dosing for the Critically Ill: A Retrospective Analysis of Clinical Experience with Dosing Software and Therapeutic Drug Monitoring to Optimize Antimicrobial Dosing.Antibiotics (Basel, Switzerland) · 2021Article
- Clinician preferences for prescription of corticosteroids in patients with septic shock: an international survey.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2021Article
- Article
- Selective decontamination of the digestive tract in critical care: a teenage angst or coming of age issue?Critical care (London, England) · 2018Article
- Urosepsis--Etiology, Diagnosis, and Treatment.Deutsches Arzteblatt international · 2015Review
- It's About Time ….Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2015Article
- Earliest Bedside Assessment of Hemodynamic Parameters and Cardiac Biomarkers: Their Role as Predictors of Adverse Outcome in Patients with Septic Shock.International journal of medical sciences · 2015Article
- Management of sepsis in neutropenic patients: 2014 updated guidelines from the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO).Annals of hematology · 2014Review
- Current Use of Steroids in Critical Care.SOJ anesthesiology & pain management · 2014Article
- Septic serum induces glucocorticoid resistance and modifies the expression of glucocorticoid isoforms receptors: a prospective cohort study and in vitro experimental assay.Critical care (London, England) · 2013Article
- Clinical review: International comparisons in critical care - lessons learned.Critical care (London, England) · 2012Review
- Low-dose steroids in adult septic shock: results of the Surviving Sepsis Campaign.Intensive care medicine · 2012Article
- Sepsis: a review for the neurohospitalist.The Neurohospitalist · 2012Article
- Early initiation of low-dose corticosteroid therapy in the management of septic shock: a retrospective observational study.Critical care (London, England) · 2012Article
Corrections and comments
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Authors and funding
15 authors at 11 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe benefits and use of low-dose corticosteroids (LDCs) in severe sepsis and septic shock remain controversial. Surviving sepsis campaign guidelines suggest LDC use for septic shock patients poorly responsive to fluid resuscitation and vasopressor therapy. Their use is suspected to be wide-spread, but paucity of data regarding global practice exists. The purpose of this study was to compare baseline characteristics and clinical outcomes of patients treated or not treated with LDC from the international PROGRESS (PROmoting Global Research Excellence in Severe Sepsis) cohort study of severe sepsis.
methodsPatients enrolled in the PROGRESS registry were evaluated for use of vasopressor and LDC (equivalent or lesser potency to hydrocortisone 50 mg six-hourly plus 50 microg 9-alpha-fludrocortisone) for treatment of severe sepsis at any time in intensive care units (ICUs). Baseline characteristics and hospital mortality were analyzed, and logistic regression techniques used to develop propensity score and outcome models adjusted for baseline imbalances between groups.
resultsA total of 8,968 patients with severe sepsis and sufficient data for analysis were studied. A total of 79.8% (7,160/8,968) of patients received vasopressors, and 34.0% (3,051/8,968) of patients received LDC. Regional use of LDC was highest in Europe (51.1%) and lowest in Asia (21.6%). Country use was highest in Brazil (62.9%) and lowest in Malaysia (9.0%). A total of 14.2% of patients on LDC were not receiving any vasopressor therapy. LDC patients were older, had more co-morbidities and higher disease severity scores. Patients receiving LDC spent longer in ICU than patients who did not (median of 12 versus 8 days; P <0.001). Overall hospital mortality rates were greater in the LDC than in the non-LDC group (58.0% versus 43.0%; P <0.001). After adjusting for baseline imbalances, in all mortality models (with vasopressor use), a consistent association remained between LDC and hospital mortality (odds ratios varying from 1.30 to 1.47).
conclusionsWidespread use of LDC for the treatment of severe sepsis with significant regional and country variation exists. In this study, 14.2% of patients received LDC despite the absence of evidence of shock. Hospital mortality was higher in the LDC group and remained higher after adjustment for key determinates of mortality.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.