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dc.contributor.authorCohen, Jeremy-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorBillot, Laurent-
dc.contributor.authorBurrell, Louise M-
dc.contributor.authorEvans, David M-
dc.contributor.authorFinfer, Simon-
dc.contributor.authorHammond, Naomi E-
dc.contributor.authorLi, Qiang-
dc.contributor.authorLiu, David Shi Hao-
dc.contributor.authorMcArthur, Colin-
dc.contributor.authorMcWhinney, Brett-
dc.contributor.authorMoore, John-
dc.contributor.authorMyburgh, John-
dc.contributor.authorPeake, Sandra-
dc.contributor.authorPretorius, Carel-
dc.contributor.authorRajbhandari, Dorrilyn-
dc.contributor.authorRhodes, Andrew-
dc.contributor.authorSaxena, Manoj-
dc.contributor.authorUngerer, Jacobus Pj-
dc.contributor.authorYoung, Morag J-
dc.contributor.authorVenkatesh, Balasubramanian-
dc.identifier.citationAmerican Journal of Respiratory and Critical Care Medicine 2020; 202(5): 700-707en_US
dc.description.abstractWhether biomarkers can identify subgroups of patients with septic shock with differential treatment responses to hydrocortisone is unknown. To determine if there is heterogeneity in effect for hydrocortisone on mortality, shock resolution and other clinical outcomes based on baseline cortisol, aldosterone and ascorbic acid concentrations. From May 2014 to April 2017, we obtained serum samples from 529 patients with septic shock from 22 intensive care units in Australia and New Zealand. There were no significant interactions between the association with 90-day mortality and treatment with either hydrocortisone or placebo for total cortisol (odds ratio 1.09, 95% confidence interval 1.02-1.16, vs odds ratio 1.07, 95% confidence interval 1.00-1.13, p=0.70), free cortisol (odds ratio 1.20, 95% confidence interval 1.04-1.38 vs odds ratio 1.16, 95% confidence interval 1.02-1.32, p=0.75), aldosterone (odds ratio 1.01, 95% confidence interval 0.97-1.05, vs odds ratio 1.01, 95% confidence interval 0.98-1.04, p=0.99), or ascorbic acid (odds ratio 1.11, 95% confidence interval 0.89-1.39 vs odds ratio 1.05, 95% confidence interval 0.91-1.22, p=0.70) respectively. Similar results were observed for the association with shock resolution. Elevated free cortisol was significantly associated with 90-day mortality (odds ratio 1.13, 95% confidence interval 1.00-1.27, p=0.04) but total cortisol, aldosterone and ascorbic acid were not. In patients with septic shock, there was no heterogeneity in effect of adjunctive hydrocortisone on mortality, shock resolution or other clinical outcomes based on cortisol, aldosterone and ascorbic acid concentrations. Plasma aldosterone and ascorbic acid concentrations are not associated with outcome.en_US
dc.subjectAscorbic Aciden_US
dc.subjectSeptic Shocken_US
dc.titlePlasma Cortisol, Aldosterone, and Ascorbic Acid Concentrations in Patients with Septic Shock do not Predict Treatment Effect of Hydrocortisone on Mortality: A Nested Cohort Study.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAmerican Journal of Respiratory and Critical Care Medicineen_US
dc.identifier.affiliationUniversity of New South Wales, St George Clinical School, Sydney, New South Wales, Australiaen_US
dc.identifier.affiliationThe University of Adelaide, 1066, Adelaide, South Australia, Australiaen_US
dc.identifier.affiliationMonash University, 2541, Clayton, Victoria, Australiaen_US
dc.identifier.affiliationPathology Queensland, Department of Chemical Pathology, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationHudson Institute of Medical Research, 518514, Clayton, Victoria, Australiaen_US
dc.identifier.affiliationGeneral Medicineen_US
dc.identifier.affiliationAustin Healthen_US
dc.identifier.affiliationGeorge Institute for Global Health, 211065, Sydney, New South Wales, Australiaen_US
dc.identifier.affiliationTranslational Research Institute Australia, 373031, South Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationUniversity of Bristol, 1980, Medical Research Council Integrative Epidemiology Unit, Bristol, United Kingdom of Great Britain and Northern Irelanden_US
dc.identifier.affiliationUniversity of Sydney, Intensive Care, St. Leonards, New South Wales, Australiaen_US
dc.identifier.affiliationRoyal Brisbane and Women's Hospital, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationHealth Support Queensland Pathology Queensland, 139306, Herston, Queensland, Australiaen_US
dc.identifier.affiliationSunshine Coast University College, 5333, Maroochydore DC, Queensland, Australiaen_US
dc.identifier.affiliationAuckland City Hospital, Intensive Care, Auckland, New Zealanden_US
dc.identifier.affiliationSt Georges Hospital, London, United Kingdom of Great Britain and Northern Irelanden_US
dc.type.austinJournal Article-, Rinaldo
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.grantfulltextnone- Care- Analytics Research and Evaluation (DARE) Centre- Medicine- (University of Melbourne)-
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