2018, Number 1
Med Crit 2018; 32 (1)
Association between serum cortisol level and mortality in post-surgical patients with hemorrhagic hypovolemic shock
Díaz GSP, Sánchez DJS, Martínez REA, García MRC, Peniche MKG, Calyeca SMV
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ABSTRACTIntroduction: The use of corticosteroids for the treatment of patients with septic shock has led to consider their use in other pathological processes, including hypovolemic hemorrhagic shock, although with controversial results.
Material and methods: A prospective, longitudinal, observational and analytical cohort study was conducted. We included patients admitted to the intensive care unit (ICU) with a diagnosis of hypovolemic hemorrhagic shock secondary to a surgical event in the period from January 1 to July 31 of 2017.
Results: The cutoff point for serum cortisol at ICU admission was established using the ROC curve, estimated at 39.1 µg/dL, with an area under the curve of 1.00 (95%CI 0.0012-0.2487, p = 0.0001). Sensitivity was 100%, with a specificity of 100%. The positive and negative probability coefficients were 14 and zero, respectively.
Conclusion: Serum cortisol levels measured at admission to the ICU greater than 39.1 µg/dL are associated with higher mortality in post-surgical patients with hypovolemic hemorrhagic shock.