To the Editor: Dr Annane and colleagues1 claim that corticotropin nonresponders with septic
shock who were treated with corticosteroids had a significantly decreased
mortality. This claim is based on an adjusted Cox model that corrects for
baseline cortisol, cortisol response to tetracosactin, McCabe classification,
Logistic Organ Dysfunction score, arterial lactate concentration, and PAO2/Fio2. The authors were able to show a modest decrease in
mortality only after correcting for these factors.
Millo J. Corticosteroids for Patients With Septic Shock. JAMA. 2003;289(1):41-44. doi:10.1001/jama.289.1.41-a