Effects of plasma cortisol levels and corticosteroid therapy on mortality in septic shock patients Septik şok ile izlenen hastalarda, plazma kortizol düzeyinin ve steroid tedavisinin mortalite üzerine etkileri

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Talan L., Bikmaz G. A., Cakir N., Turkoglu M. A.

Gazi Medical Journal, cilt.26, sa.4, ss.139-142, 2015 (Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 4
  • Basım Tarihi: 2015
  • Doi Numarası: 10.12996/gmj.2015.43
  • Dergi Adı: Gazi Medical Journal
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.139-142
  • Anahtar Kelimeler: Corticosteroid teratment, Cortisol levels, Icu, Mortality, Septic shock
  • Gazi Üniversitesi Adresli: Evet

Özet

© Copyright 2015 by Gazi University Medical Faculty.Objective: In patients with refractory septic shock corticosteroid therapy has been shown to improve hemodynamic instability. This has been named as critical illness related adrenal insufficiency. Several studies had been done on significance of corticosteroid treatment in vasopressor dependent patients. As well it is recommended in guidelines. The aim of this study was to study the effects of plasma Cortisol levels and corticosteroid therapy on intensive care unit(ICU) mortality of the patients. Material and methods: Patients who were hospitalized with septic shock at Gazi University Faculty of Medicine medical intensive care unit between February 2008- October 2010 were rewieved retrospectively. Patients whose Cortisol levels were measured and corticosteroid treatment was started at the begining of septic shock state enrolled. Age, sex, length of ICU stay, need for mechanical ventilation, APACHE II and glascow score, albumin, C reactive protein, spot blood sugar levels and daily insulin doses were recorded. Length of ICU stay, mortality and reversal of septic shock were choosen as the end points of the study. Results: Totally 91 patients were enrolled. Patients were grouped into two; according to their plasma Cortisol levels (<15 μg/dLand >15 μ/dL). In 22 patients (24,2 %) plasma Cortisol level was <15 μg/dL. There was no statiscal signifance between two groups' demographic variables. However in the plasma Cortisol levels > 15 μg / dL group, independent of steroid treatment, ICU mortality rate was significantly higher. Patients were grouped depending on whether they received steroid treatment. There was no mortality difference but in the steroid treatment group length of stay in ICU was significantly shorter. Conclusion: Patients whose plasma Cortisol levels were >15 ng/dL had higher ICU mortality. Corticosteroid treatment was associated with shorter length of ICU stay.