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Annals of Hematology

, Volume 98, Issue 10, pp 2311–2318 | Cite as

Effect of adjunctive corticosteroid on 28-day mortality in neutropenic patients with septic shock

  • Jieun Kang
  • Minkyu Han
  • Sang-Bum Hong
  • Chae-Man Lim
  • Younsuck Koh
  • Jin Won HuhEmail author
Original Article
  • 65 Downloads

Abstract

The role of adjunctive corticosteroid in septic shock remains debatable, and its role has not been assessed in neutropenic patients. We evaluated whether hydrocortisone reduces 28-day mortality in neutropenic patients with septic shock. We conducted a retrospective cohort study between January 2012 and May 2017 at a tertiary care center in South Korea. Patients who developed septic shock treated with at least one vasopressor and whose absolute neutrophil count was < 1000 cells/μL were included. Patients were classified into a steroid and a no-steroid group. The primary outcome of the study was 28-day mortality. Propensity score matching was used to adjust baseline characteristics and disease severity between the groups. Of the 287 patients analyzed, 189 were classified in the no-steroid group and 98 in the steroid group. Fifty propensity score–matched pairs were compared for the study outcomes. We found no significant difference in 28-day mortality between patients treated with and without steroid after propensity score matching (38.0% and 42.0%, respectively; p = 0.838). Incidences of pneumonia and gastrointestinal bleeding were more frequent in the steroid group, but it was not statistically significant after matching. In conclusion, adjunctive hydrocortisone was not associated with reduced 28-day mortality in neutropenic patients with septic shock.

Keywords

Corticosteroids Neutropenia Sepsis Septic shock 

Abbreviations

G-CSF

Granulocyte colony-stimulating factor

ICU

Intensive care unit

PS

Propensity score

SOFA

Sequential organ failure assessment

Notes

Compliance with ethical standards

The study protocol was approved by the institutional review board of Asan Medical Center (No. 2018-0206), and the need for informed consent was waived due to the retrospective nature of the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2019_3785_MOESM1_ESM.docx (24 kb)
ESM 1 (DOCX 24 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pulmonary and Critical Care Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  2. 2.Department of Clinical Epidemiology and Biostatistics, Asan Medical CenterSeoulSouth Korea

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