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Letters
October 21, 2009

Corticosteroid Therapy for Severe Sepsis and Septic Shock

JAMA. 2009;302(15):1643-1645. doi:10.1001/jama.2009.1481

To the Editor: Dr Annane and colleagues1 conducted a systematic review and meta-analysis of the use of corticosteroids in the treatment of sepsis and septic shock. In thinking about future research, we would like to raise a question about the statistical methods that have been used to evaluate shock reversal after steroid use. This is a situation of competing risks because another end point (death) may occur before shock reversal.

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