Evidence map›Paper›PMID 24589640›Full record

Trial reportCritical care medicine2014

Corticosteroids and transition to delirium in patients with acute lung injury.

Matthew P Schreiber, Elizabeth Colantuoni, Oscar J Bienvenu, Karin J Neufeld, Kuan-Fu Chen, Carl Shanholtz, Pedro A Mendez-Tellez, Dale M Needham

Abstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 4 pooled it
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Risk factors for physical impairment after acute lung injury in a national, multicenter study.American journal of respiratory and critical care medicine · 2014
    Trial
  7. Review
  8. Prevention and Treatment of ICU Delirium in Brain Injured Patients.Current neurology and neuroscience reports · 2026
    Review
  9. Article
  10. Observational
  11. Review
  12. Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Review
  18. The past, present and future of anticholinergic drugs.Therapeutic advances in psychopharmacology · 2023
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Matthew P Schreiber1Division of Pulmonary and Critical Care, University of Nevada School of Medicine, Las Vegas, NV. 2Department of Biostatistics, Johns Hopkins University, Baltimore, MD. 3Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD. 4Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD. 5Department of Emergency Medicine, Chang Gung University and Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan 6Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, MD. 7Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University, Baltimore, MD. 8Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD. 9Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD.
Elizabeth Colantuoni
Oscar J Bienvenu
Karin J Neufeld
Kuan-Fu Chen
Carl Shanholtz
Pedro A Mendez-Tellez
Dale M Needham
Johns Hopkins University · USChang Gung University · TWUniversity of Maryland, Baltimore · USUniversity of Nevada, Las Vegas · US

Funding

Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
VENTILATOR ASSOCIATED LUNG INJURY: MOLECULAR APPROACHESP50HL073994 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI NATARAJAN, VISWANATHAN · 2003 to 2007
$21.3M
NHLBI NIH HHS P050 HL73994NHLBI NIH HHS P50 HL073994
6 · The paper itself

Abstract

objectiveDelirium is common in mechanically ventilated patients in the ICU and associated with short- and long-term morbidity and mortality. The use of systemic corticosteroids is also common in the ICU. Outside the ICU setting, corticosteroids are a recognized risk factor for delirium, but their relationship with delirium in critically ill patients has not been fully evaluated. We hypothesized that systemic corticosteroid administration would be associated with a transition to delirium in mechanically ventilated patients with acute lung injury.

designProspective cohort study.

settingThirteen ICUs in four hospitals in Baltimore, MD. PATIENTS: Five hundred twenty mechanically ventilated adult patients with acute lung injury.

interventionsNone. MEASUREMENTS AND MAIN

resultsDelirium evaluation was performed by trained research staff using the validated Confusion Assessment Method for the ICU screening tool. A total of 330 of the 520 patients (64%) had at least two consecutive ICU days of observation in which delirium was assessable (e.g., patient was noncomatose), with a total of 2,286 days of observation and a median (interquartile range) of 15 (9, 28) observation days per patient. These 330 patients had 99 transitions into delirium from a prior nondelirious, noncomatose state. The probability of transitioning into delirium on any given day was 14%. Using multivariable Markov models with robust variance estimates, the following factors (adjusted odds ratio; 95% CI) were independently associated with transition to delirium: older age (compared to < 40 years old, 40-60 yr [1.81; 1.26-2.62], and ≥ 60 yr [2.52; 1.65-3.87]) and administration of any systemic corticosteroid in the prior 24 hours (1.52; 1.05-2.21).

conclusionsAfter adjusting for other risk factors, systemic corticosteroid administration is significantly associated with transitioning to delirium from a nondelirious state. The risk of delirium should be considered when deciding about the use of systemic corticosteroids in critically ill patients with acute lung injury.

Indexed as

Respiration, ArtificialAcute Lung InjuryAdrenal Cortex HormonesAdultAge FactorsAPACHECritical IllnessDeliriumFemaleHumansIntensive Care UnitsMaleMarkov ChainsMiddle AgedOrgan Dysfunction ScoresProspective StudiesAdrenal Cortex Hormones

Identifiers

PMID24589640
PMCPMC4028387
OpenAlexW2084403343

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.