Evidence map›Paper›PMID 36741650›Full record

ArticleCureus2023

The Association of Corticosteroid Therapy With Mortality and Length of Stay Among Children With Septic Shock: A Retrospective Cohort Study.

Hamad A Alkhalaf, Nawaf A Alhamied, Abdulmajeed M Alqahtani, Faisal A Alsomali, Malek A Alrasheed, Mohammed M Alhafi, Muhannad Q Alqirnas, Fawaz A Alhamied, Faris M Albaqami, Abdulaziz S Almosa and 2 more

Abstract read
In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
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

12 authors.

Hamad A AlkhalafDepartment of Pediatrics, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU.
Nawaf A AlhamiedDepartment of Pediatrics, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU.
Abdulmajeed M AlqahtaniCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Faisal A AlsomaliCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Malek A AlrasheedCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Mohammed M AlhafiCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Muhannad Q AlqirnasCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Fawaz A AlhamiedCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Faris M AlbaqamiCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Abdulaziz S AlmosaCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Fatmah OthmanCollege of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Mohammed NaeemIntensive Care Unit, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction Septic shock remains a leading cause of mortality in pediatric patients. Corticosteroids have been used in the management of sepsis and septic shock, but there is conflicting evidence on the potential benefit of corticosteroid therapy. This study assessed the risk of mortality and length of stay in the pediatric intensive care unit (PICU) among pediatric patients admitted with a septic shock diagnosis. Method A retrospective cohort study was conducted among pediatric patients (up to 14 years old) admitted with a septic shock diagnosis to the PICU of King Abdullah Specialist Children's Hospital in Riyadh from January 2016 to December 2021. The clinical outcomes of patients receiving corticosteroid therapy were compared to those of control patients who were not given corticosteroids. Electronic medical records provided clinical data, severity scores, and the management given for each patient. The patients were followed up from the date of sepsis diagnosis to hospital discharge. Proportional hazard ratios (HRs) were calculated to compare the risk of mortality, length of PICU stay, and length of hospital stay. Results A total of 182 pediatric patients were included in the study, and 86 (47%) received corticosteroid therapy. The median age of the study population was 15 months (interquartile range [IQR]: 2-72 months). Compared to the controls, the patients who received corticosteroids had a higher total Sequential Organ Failure Assessment (SOFA) score (mean±SD: 5.5±3 vs. 7.1±3.3, respectively; p <0.01) and required more ventilation support (72% vs. 28%, respectively) and the use of inotropes and vasopressors (74% vs. 34% and 32% vs. 6%, respectively). In-hospital mortality did not significantly differ between the groups (adjusted HR: 2.66; 95% confidence interval [CI]: 0.66-10.28). Those patients who received corticosteroids had 42% less risk of staying in the PICU for over six days than those not receiving steroids (HR: 0.35; 95% CI: 0.13-0.98) Conclusion After adjusting for baseline characteristics, severity scores, and medical intervention, no association was found between receiving corticosteroids and mortality (p=0.492). Furthermore, patients who received corticosteroids had less risk of a prolonged stay in the PICU than those who did not.

Indexed as

corticosteroidspeditric sepsissaudi arabiasepsisseptic shocksevere sepsis

Identifiers

PMID36741650
PMCPMC9891713

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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.