Evidence map›Paper›PMID 26753096›Full record

ArticleJournal of intensive care2016

Comparison of total, salivary and calculated free cortisol levels in patients with severe sepsis.

Gulsah Elbuken, Zuleyha Karaca, Fatih Tanriverdi, Kursad Unluhizarci, Murat Sungur, Mehmet Doganay, Fahrettin Kelestimur

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Journal of intensive care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02589431 (Comparison of Total, Salivary and Calculated Free Cortisol Levels in Patients With Severe Sepsis), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 22% 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.

NCT02589431 completednot on this map

Comparison of Total, Salivary and Calculated Free Cortisol Levels in Patients With Severe Sepsis

TypeobservationalSponsorTC Erciyes UniversityRan2009 to 2011Enrolled46ConditionsSevere Sepsis
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Gulsah ElbukenDepartment of Endocrinology and Metabolism, Erciyes University Medical School, 38039 Kayseri, Turkey.
Zuleyha KaracaDepartment of Endocrinology and Metabolism, Erciyes University Medical School, 38039 Kayseri, Turkey.
Fatih TanriverdiDepartment of Endocrinology and Metabolism, Erciyes University Medical School, 38039 Kayseri, Turkey.
Kursad UnluhizarciDepartment of Endocrinology and Metabolism, Erciyes University Medical School, 38039 Kayseri, Turkey.
Murat SungurDepartment of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey.
Mehmet DoganayDepartment of Infectious Diseases, Erciyes University Medical School, Kayseri, Turkey.
Fahrettin KelestimurDepartment of Endocrinology and Metabolism, Erciyes University Medical School, 38039 Kayseri, Turkey.
Erciyes University · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe purposes of the study were to compare serum total cortisol (STC), salivary cortisol (SaC) and calculated free cortisol (cFC) levels at baseline and after the adrenocorticotrophic hormone (ACTH) stimulation test in patients with severe sepsis (SS) and determine the suitability of use of SaC and cFC levels instead of STC for the diagnosis of adrenal insufficiency (AI) in patients with SS. And secondary aims of this study were to compare these parameters in patients with SS with healthy controls and check their effects on survival status of the patients.

methodsThirty patients with SS (15 men and 15 women) were compared with 16 healthy controls. Low-dose (1 μg) ACTH stimulation test was performed to the patients on the first, seventh and 28th days of diagnosis of SS, but in control group, 1 μg ACTH stimulation test was performed only once. STC, SaC and cFC levels were measured during ACTH stimulation test.

resultsPatients were categorized as having low or high baseline STC according to a cut-off level of 10 μg/dL. In high STC group, baseline and peak SaC levels were found to be 2.3 (0.2-9.0) and 3.4 (0.5-17.8) μg/dL on D1 and 1.1 (0.8-4.6) and 2.6 (1.3-2.9) μg/dL on D7, respectively. In the control group, baseline and peak SaC levels were 0.4 (0.1-1.4) and 1.1 (0.4-2.5) μg/dL, respectively. Baseline and peak SaC levels after ACTH stimulation were found to be higher in high STC group than in controls, but they were found to be similar in low STC and control groups. In high STC group, cFC levels were 0.3 (0.1-0.3) and 0.4 (0.3-0.7) μg/dL on D1 and 0.2 (0.1-0.3) and 0.4 (0.1-0.7) μg/dL on D7, respectively. In the control group, baseline and peak cFC levels were 1.7 (0.4-1.9) and 1.8 (1.0-6.6) μg/dL, respectively. cFC levels were found to be lower in patients with SS subgroups than in the control group. Baseline and stimulated STC, SaC and cFC levels did not differ according to the survival status. SaC, cFC and STC levels were found to be correlated with each other.

conclusionsSS is associated with increased SaC, but decreased cFC levels when baseline STC is assumed to be sufficient. When STC level is assumed to be insufficient, SaC levels remain unchanged, but cFC levels are decreased. Lower STC levels is not associated with increased mortality in patients with SS. More data are needed in order to suggest the use of SaC and cFC instead of STC.

trial registrationClinicalTrials.gov No: NCT02589431.

Indexed as

ACTH stimulation testCalculated free cortisolHPA axisSalivary cortisolSevere sepsisTotal cortisol

Identifiers

PMID26753096
PMCPMC4706674
OpenAlexW2228449224

What OpenQuestion holds

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LicenceCC BY
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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.