{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T17:34:20Z","timestamp":1776274460794,"version":"3.50.1"},"reference-count":38,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T00:00:00Z","timestamp":1644710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Royal Adelaide Hospital Research Committee","award":["7652"],"award-info":[{"award-number":["7652"]}]},{"name":"Royal Adelaide Hospital Research Committee","award":["10164"],"award-info":[{"award-number":["10164"]}]},{"name":"Clinical Project Grant","award":["7528"],"award-info":[{"award-number":["7528"]}]},{"name":"Royal Adelaide Hospital Research Committee Dawes","award":["8580"],"award-info":[{"award-number":["8580"]}]},{"name":"Royal Adelaide Hospital Research Committee Dawes","award":["10905"],"award-info":[{"award-number":["10905"]}]},{"name":"Royal Adelaide Hospital Research Committee Mary Overton Research Fellowship","award":["9757"],"award-info":[{"award-number":["9757"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Hydrocortisone administration in septic shock remains controversial. Corticosteroid-binding globulin (CBG) transports cortisol to inflammatory sites and is depleted in septic shock.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine whether severely deficient serum CBG\u2005&amp;lt;\u2005200 nmol\/L (reference range 269-641 nmol\/L) independently predicts septic shock mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective observational study in patients with septic shock. Patients were categorized into 2 groups: mean plasma CBG concentrations &amp;lt;200 nmol\/L and \u2265200 nmol\/L (day 1\/2), with additional categorization by nadir CBG. Primary outcome was intensive care unit (ICU) mortality. Secondary outcomes were 28- and 90-day mortality, norepinephrine requirements, renal replacement therapy, and clinician-instituted hydrocortisone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>135 patients were included. Mortality rates in ICU were higher in the CBG\u2005&amp;lt;\u2005200 nmol\/L vs the CBG\u2005\u2265\u2005200 nmol\/L group: 32.4% vs 13.9% [odds ratio (OR) 2.97 (95% CI 1.19, 7.41); P\u2005=\u20050.02] with 28-day mortality OR 2.25 (95% CI 0.99, 5.11) and 90-day mortality OR 2.21 (95% CI 0.99, 4.91). Multivariate analysis revealed 4 factors independently associated with ICU mortality: CBG\u2005&amp;lt;\u2005200 nmol\/L (adjusted OR 3.23, 95% CI 1.06, 9.88), Acute Physiology and Chronic Health Evaluation II\u2005&amp;gt;\u200525 (adjusted OR 3.58, 95% CI 1.20, 10.68), Sequential Organ Failure Assessment (SOFA) liver score (adjusted OR 1.98, 95% CI 1.04, 3.72), and renal replacement therapy (adjusted OR 6.59, 95% CI 2.17, 20.01). Nadir CBG levels were associated with higher SOFA cardiovascular scores and norepinephrine total dose (\u03bcg; P\u2005&amp;lt;\u20050.01) and duration (days; P\u2005&amp;lt;\u20050.01). Plasma cortisol concentrations and hydrocortisone administration did not relate to ICU mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Septic shock patients with CBG\u2005&amp;lt;\u2005200 nmol\/L had higher norepinephrine requirements and 3.2-fold higher ICU mortality. CBG concentration was the only directly reversible independent mortality risk factor.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgac035","type":"journal-article","created":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T17:44:01Z","timestamp":1644774241000},"page":"1636-1646","source":"Crossref","is-referenced-by-count":20,"title":["Corticosteroid-Binding Globulin Deficiency Independently Predicts Mortality in Septic Shock"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7450-5808","authenticated-orcid":false,"given":"Emily Jane","family":"Meyer","sequence":"first","affiliation":[{"name":"Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia"},{"name":"Endocrine and Diabetes Services, The Queen Elizabeth Hospital, Woodville South, Australia"},{"name":"Discipline of Medicine, University of Adelaide, Adelaide, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marni 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