A retrospective analysis of a multicenter prospective cohort study evaluated the association between steroid administration, including hydrocortisone timing and dose, and mortality in patients with septic shock in the ED.
Study findings: Steroid use was associated with lower 28-day mortality (p = 0.001). This association remained in the vasopressin subgroup (p < 0.001) but not in patients who did not receive vasopressin (p = 0.769). A higher norepinephrine-equivalent dose at first steroid administration, a longer interval from first vasopressor initiation to first steroid administration, and hydrocortisone dosing > 300 mg/day were associated with increased mortality.
Bottom line: Steroid administration in the ED was associated with lower 28-day mortality among patients with septic shock, particularly those receiving vasopressin.
References
Ahn S, et al. Steroid administration, timing, and dose in patients with septic shock in the emergency department: retrospective analysis of a multicenter prospective cohort study. Sci Rep. 2026 Jun 13;16(1):26929. doi: 10.1038/s41598-026-56521-6.