ArticlePloS one2014
Corticosteroids and pediatric septic shock outcomes: a risk stratified analysis.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled 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.
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
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children.Intensive care medicine · 2020Guideline
- Trial
- External Validation, Molecular Signatures, and Therapeutic Relevance of Pediatric Sepsis-Associated Acute Kidney Injury Subphenotypes.Critical care medicine · 2026Observational
- M2 microglial exosomal miR-1949 ameliorates sepsis-associated encephalopathy through DKK1/Wnt/β-catenin-mediated microglial repolarization.Archives of pharmacal research · 2026Article
- Corticosteroids in Pediatric Septic Shock: A Narrative Review.Journal of personalized medicine · 2024Review
- Applying Artificial Intelligence in Pediatric Clinical Trials: Potential Impacts and Obstacles.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- Therapeutically Fine-Tuning Autonomic Nervous System to Treat Sepsis: A New Perspective on the Immunomodulatory Effects of Acupuncture.Journal of inflammation research · 2024Review
- Epidemiology and clinical characteristics of pediatric sepsis in PICUs of China: A national cross-sectional study.MedComm · 2023Article
- Article
- Proteomic analysis identified potential age-associated prognostic biomarkers in pneumonia-derived paediatric sepsis.Proteomics. Clinical applications · 2022Article
- [Paediatric Life Support].Notfall & rettungsmedizin · 2021Review
- Prognostic and predictive enrichment in sepsis.Nature reviews. Nephrology · 2020Review
- Prospective clinical testing and experimental validation of the Pediatric Sepsis Biomarker Risk Model.Science translational medicine · 2019Article
- Precision medicine in pediatric sepsis.Current opinion in pediatrics · 2019Review
- Sepsis and Pediatric Acute Respiratory Distress Syndrome.Journal of pediatric intensive care · 2019Review
- Sepsis Biomarkers.Journal of pediatric intensive care · 2019Review
- Evidence of Endotypes in Pediatric Acute Hypoxemic Respiratory Failure Caused by Sepsis.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2019Article
- Hypofibrinogenemia Is Associated With Poor Outcome and Secondary Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome in Pediatric Severe Sepsis.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2018Observational
- Corticosteroids in Pediatric Septic Shock Are Not Helpful.Critical care medicine · 2018Article
- Endotype Transitions During the Acute Phase of Pediatric Septic Shock Reflect Changing Risk and Treatment Response.Critical care medicine · 2018Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 16 institutions in 1 country.
Funding
Abstract
backgroundThe potential benefits of corticosteroids for septic shock may depend on initial mortality risk.
objectiveWe determined associations between corticosteroids and outcomes in children with septic shock who were stratified by initial mortality risk.
methodsWe conducted a retrospective analysis of an ongoing, multi-center pediatric septic shock clinical and biological database. Using a validated biomarker-based stratification tool (PERSEVERE), 496 subjects were stratified into three initial mortality risk strata (low, intermediate, and high). Subjects receiving corticosteroids during the initial 7 days of admission (n = 252) were compared to subjects who did not receive corticosteroids (n = 244). Logistic regression was used to model the effects of corticosteroids on 28-day mortality and complicated course, defined as death within 28 days or persistence of two or more organ failures at 7 days.
resultsSubjects who received corticosteroids had greater organ failure burden, higher illness severity, higher mortality, and a greater requirement for vasoactive medications, compared to subjects who did not receive corticosteroids. PERSEVERE-based mortality risk did not differ between the two groups. For the entire cohort, corticosteroids were associated with increased risk of mortality (OR 2.3, 95% CI 1.3-4.0, p = 0.004) and a complicated course (OR 1.7, 95% CI 1.1-2.5, p = 0.012). Within each PERSEVERE-based stratum, corticosteroid administration was not associated with improved outcomes. Similarly, corticosteroid administration was not associated with improved outcomes among patients with no comorbidities, nor in groups of patients stratified by PRISM.
conclusionsRisk stratified analysis failed to demonstrate any benefit from corticosteroids in this pediatric septic shock cohort.
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Registered trials
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.