Observational studyBMJ paediatrics open2025
Association of systemic corticosteroids and clinical outcomes in children hospitalised with severe orbital infections.
Observational study in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07345819 (Dexamethasone vs. Placebo in Children and Youth Hospitalized for Orbital Cellulitis), which is not on this map. Not yet cited in PubMed.
What it found
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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.
Dexamethasone vs. Placebo in Children and Youth Hospitalized for Orbital Cellulitis: the VISION Pilot Randomized Clinical Trial
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the association between corticosteroid use and clinical outcomes in children hospitalised with severe orbital infections, and to describe practice patterns of systemic corticosteroid use.
designMulti-site observational cohort study using hospital data from 2009 to 2018.
settingCanadian children's hospitals (7) and community hospitals (3). PATIENTS: Children 2 months and 18 years hospitalised with severe orbital infections.
interventionsSystemic corticosteroids at any time
main outcome measuresLength of hospital stay and surgical intervention using time-to-event Cox proportional hazards multivariable regression models to account for potential differences in timing of corticosteroid use (early, ≤24 hours or late, >24 hours after admission), with adjustment for covariates.
resultsOf the 1479 hospitalised children, 876 (59.2%) were male and median age was 5.3 years (IQR 2.2 to 9.8). Of the 65 (4.4%) who received corticosteroids, over half (53.8%) received them early. Median length of stay was 75.9 hours (IQR 47.1 to 130.4) and 98 (6.6%) underwent surgical intervention. Corticosteroid use was associated with delayed discharge and prolonged hospitalisation, as reflected by a HR of 0.73 (95% CI 0.55 to 0.96) in adjusted analyses. However, systemic corticosteroids had no association with surgical intervention (HR 0.82, 95% CI 0.36 to 1.88).
conclusionIn a large cohort of hospitalised children with severe orbital infections, corticosteroids were used infrequently, and when used, were not associated with improved clinical outcomes. Further high-quality trial evidence is needed to determine if routine corticosteroids are safe and effective.
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