Evidence map›Paper›PMID 29058223›Full record

ArticleAnnals of intensive care2017

Protective effect of early low-dose hydrocortisone on ventilator-associated pneumonia in the cancer patients: a propensity score analysis.

David Lagier, Laura Platon, Jérome Lambert, Laurent Chow-Chine, Antoine Sannini, Magali Bisbal, Jean-Paul Brun, Karim Asehnoune, Marc Leone, Marion Faucher and 1 more

Open access · goldAbstract read
In one paragraph

Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 43% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
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

11 authors at 4 institutions in 2 countries.

David LagierIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France. david.lagier@ap-hm.fr.
Laura PlatonIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
Jérome LambertBiostatistics Department, Saint Louis Teaching Hospital, AP-HP, 1, Avenue Claude Vellefaux, 75010, Paris, France.
Laurent Chow-ChineIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
Antoine SanniniIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
Magali BisbalIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
Jean-Paul BrunIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
Karim AsehnouneDepartment of Anesthesiology and Critical Care Medicine, Hotel Dieu, University Hospital of Nantes, 1 Place Alexis Ricordeau, 44903, Nantes, France.
Marc LeoneDepartment of Anesthesiology and Critical Care Medicine, Hopital Nord, University Hospital of Marseille, Chemin des Bourrely, 13015, Marseille, France.
Marion FaucherIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
Djamel MokartIntensive Care Unit, Paoli-Calmettes Institute, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
Institut Paoli-Calmettes · FRAssistance Publique – Hôpitaux de Paris · FRHôpital Nord · FRHotel Dieu Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVentilator-associated pneumonia (VAP) is a care-related event that could be promoted by immune suppression caused by critical diseases, malignancies and cancer treatments. Low dose of hydrocortisone was proposed for modulation of immune response in the critically ill population.

methodsIn this monocentric observational study, all cancer patients mechanically ventilated for more than 48 h were included. Effect of low-dose hydrocortisone administered during the first 48 h of mechanical ventilation was evaluated applying inverse probability weighting analysis after propensity score assessment. VAP impact on 1-year mortality, ICU length of stay and mechanical ventilation duration was secondarily determined.

resultsWithin this cohort, 190 cancer patients were followed. VAP was confirmed in 22.1% of cases in the early hydrocortisone group and confirmed in 42.6% of cases in the no or late hydrocortisone group. Early hydrocortisone exhibited a protective effect on the risk of VAP (OR 0.23; 95% CI 0.12-0.44; P < 0.0001). VAP was associated with 1-year mortality (HR 1.60; 95% CI 1.10-2.34; P = 0.017) and increased ICU length of stay (mean extra length of stay: 4.2 days; 95% CI 0.6-7.8).

conclusionsImmune modulation with low-dose hydrocortisone administered in the first days of mechanical ventilation could protect from VAP occurrence in cancer patients.

Indexed as

HydrocortisoneImmunomodulationNeoplasmsPropensity scoreVentilator-associated pneumonia

Identifiers

PMID29058223
PMCPMC5651535
OpenAlexW2767079157

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.