ArticlePloS one2014
Association of adrenal function and disease severity in community-acquired pneumonia.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers, 2 of them syntheses 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.
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.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Efficacy and safety of glucocorticoids in the treatment of severe community-acquired pneumonia: A meta-analysis.Medicine · 2019Pooled it
- Systematic review regarding metabolic profiling for improved pathophysiological understanding of disease and outcome prediction in respiratory infections.Respiratory research · 2015Pooled it
- Association of admission cortisol levels with outcomes and treatment response in patients at nutritional risk : A secondary analysis of a randomized clinical trial.Nutrition journal · 2023Trial
- Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study.Respiratory research · 2018Trial
- Prognostic Value of Serum Cortisol, DHEA, and SOFA Score in Adult Sepsis Patients: A Retrospective Single-Center Clinical Study.Journal of clinical medicine · 2026Article
- Anti-aging effects of the adrenal androgens dehydroepiandrosterone and dehydroepiandrosterone sulfate: mechanisms of action and beneficial effects in older people.Endocrine journal · 2026Review
- Amplified inflammatory and immune responses in viral-associated pulmonary aspergillosis.Frontiers in cellular and infection microbiology · 2026Article
- Mortality reduction in severe community-acquired pneumonia: key findings from a large randomized controlled trial and their clinical implications.Annals of translational medicine · 2023Article
- Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac).Journal of clinical medicine · 2020Review
- New insights into pediatric community-acquired pneumonia gained from untargeted metabolomics: A preliminary study.Pediatric pulmonology · 2020Article
- Investigation of serum cortisol concentration as a potential prognostic marker in hospitalized dogs: a prospective observational study in a primary care animal hospital.BMC veterinary research · 2019Article
- Dehydroepiandrosterone: a potential therapeutic agent in the treatment and rehabilitation of the traumatically injured patient.Burns & trauma · 2019Review
- Cortisol and adrenal androgens as independent predictors of mortality in septic patients.PloS one · 2019Article
- Assessing endocrine and immune parameters in human immunodeficiency virus-infected patients before and after the immune reconstitution inflammatory syndrome.Archives of endocrinology and metabolism · 2018Article
- Time-dependent association of glucocorticoids with adverse outcome in community-acquired pneumonia: a 6-year prospective cohort study.Critical care (London, England) · 2017Article
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRapid and accurate risk stratification in patients with community-acquired pneumonia (CAP) is an unmet clinical need. Cortisol to dehydroepiandrosterone (DHEA) ratio was put forward as a prognostic marker in sepsis. We herein validated the prognostic value of the adrenal hormones DHEA, DHEA-Sulfate (DHEAS), cortisol/DHEA-, cortisol/DHEAS- and DHEA/DHEAS-ratios in patients with CAP.
methodsWe assessed severity of illness using the pneumonia severity index (PSI) and measured adrenal hormone concentrations in 179 serum samples of prospectively recruited patients hospitalized with CAP. We calculated spearman rank correlation, logistic regression analysis and Kaplan Meier curves to study associations of adrenal hormones and outcomes.
resultsThere was a significant correlation between PSI score and total cortisol (r = 0.24, p = 0.001), DHEAS (r = -0.23, p = 0.002), cortisol/DHEA (r = 0.23, p = 0.003), cortisol/DHEAS (r = 0.32, p = <0.0001) and DHEA/DHEAS (r = 0.20, p = 0.009). In age and gender adjusted logistic regression analysis, cortisol (OR:2.8, 95% CI: 1.48-5.28) and DHEA (OR: 2.62,95% CI: 1.28-5.34), but not DHEAS and the different ratios were associated with all-cause mortality. The discriminatory accuracy of cortisol and DHEA in ROC analysis (area under the curve) was 0.74 and 0.61. In Kaplan Meier analysis, patients in the highest deciles of cortisol and DHEA (p = 0.005 and p = 0.015), and to a lesser extent of cortisol/DHEAS ratio (p = 0.081) had a higher risk of death.
conclusionCortisol, DHEAS and their ratios correlate with CAP severity, and cortisol and DHEA predict mortality. Adrenal function in severe pneumonia may be an important factor for CAP outcomes.
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