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January 1, 2003

Corticosteroids for Patients With Septic Shock

JAMA. 2003;289(1):41-44. doi:10.1001/jama.289.1.41-a

In Reply: Dr Brown asks whether the observed reduction in mortality was related to the inclusion of a large number of patients with absolute adrenal insufficiency. Among nonresponders, the percentage of patients with absolute adrenal insufficiency (ie, cortisol levels before and after corticotropin stimulation <18 µg/dL)1 was 45%. Removing such patients from the analysis of nonresponders increases the difference between placebo and corticosteroid groups from 10% to 17%.

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