Long-acting glucocorticoids improves survival of critically ill patients with sepsis: Study

A total of 10,707 patients with a diagnosis of Septic Patients with Acute Respiratory Failure were examined in this study; 2,298 of them died in the intensive care unit. Based on the recorded administration of long-acting glucocorticoids during intensive care unit therapy, patients were categorized into groups that had been exposed to and those who had not.

Even after controlling for adjustment in multivariable Cox regression analysis, the crude mortality rate was greater in the unexposed group than in the glucocorticoid-exposed cohort. Significant interaction effects were found by subgroup analysis, especially for patients on continuous renal replacement treatment and those with cancer.

Propensity score-matched studies, which showed persistent mortality disparities across the groups, further supported the main findings. The long-acting glucocorticoid group exhibited a substantial survival benefit over the short-acting glucocorticoid group, according to sensitivity analysis of the various treatment groups.

Overall, among critically sick septic patients with acute respiratory failure, the use of long-acting glucocorticoids was associated with a lower ICU death rate. In this high-risk patient population, this data suggests that long-acting glucocorticoid medication may offer a survival benefit.

Reference:

Deng, Y., Wang, S., Zhou, S., Zhao, W., Wang, A., & Gao, J. (2025). Impact of long-acting glucocorticoids on ICU mortality in Septic Patients with Acute Respiratory Failure: A MIMIC-IV based cohort study. Frontiers in Pharmacology, 16, 1663974. https://doi.org/10.3389/fphar.2025.1663974