| Title |
Low-dose corticosteroid treatment and mortality in refractory abdominal septic shock after emergency laparotomy
|
|---|---|
| Published in |
Annals of Intensive Care, October 2015
|
| DOI | 10.1186/s13613-015-0074-8 |
| Pubmed ID | |
| Authors |
Takashi Tagami, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga |
| Abstract |
The role of low-dose corticosteroid as an adjunctive treatment for abdominal septic shock remains controversial. We identified refractory septic shock patients who required noradrenaline and at least one of other vasopressor/inotropic (dopamine, dobutamine or vasopressin) following emergency open laparotomy for perforation of the lower intestinal tract between July 2010 and March 2013 using the Japanese Diagnosis Procedure Combination inpatient database. In-hospital mortality was compared between the low-dose corticosteroid and control groups. There were 2164 eligible patients (155 in the corticosteroid group, 2009 in the control group). We observed no significant difference between the groups in terms of in-hospital mortality in the unadjusted analysis [corticosteroid vs. control groups, 19.4 and 25.1 %, respectively; difference, -5.7 %; 95 % confidence interval (CI), -12.8 to 1.3]; however, a significant difference in in-hospital mortality was evident in the propensity score-weighted analysis (17.6 and 25.0 %, respectively; difference, -7.4 %; 95 % CI -9.9 to -5.0). An instrumental variable analysis with the hospital low-dose corticosteroid prescription proportion showed that receipt of low-dose corticosteroid was significantly associated with reduction in in-hospital mortality (differences, -13.5 %; 95 % CI -24.6 to -2.3). Low-dose corticosteroid administration may be associated with reduced in-hospital mortality in patients with refractory septic shock following emergency laparotomy for lower intestinal perforation. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 41 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 7 | 17% |
| Student > Ph. D. Student | 5 | 12% |
| Student > Doctoral Student | 4 | 10% |
| Student > Bachelor | 3 | 7% |
| Researcher | 3 | 7% |
| Other | 10 | 24% |
| Unknown | 9 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 51% |
| Nursing and Health Professions | 3 | 7% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
| Immunology and Microbiology | 2 | 5% |
| Business, Management and Accounting | 1 | 2% |
| Other | 4 | 10% |
| Unknown | 8 | 20% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 October 2015.
All research outputs
#20,295,099
of 22,831,537 outputs
Outputs from Annals of Intensive Care
#955
of 1,043 outputs
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#238,737
of 284,657 outputs
Outputs of similar age from Annals of Intensive Care
#21
of 26 outputs
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