Abstract: Objective To explore the effects of low-dose glucocorticoids on the prognosis of the elderly patients with septic shock combined with immunosuppression. Methods A total of 54 elderly patients with sepsis shock combined with immunosuppression admitted to Intensive Care Unit (ICU) and Emergency Intensive Care Unit (EICU) of Nanjing First Hospital from October 2020 to December 2023 were enrolled in this study. The patients were divided into glucocorticoids group (n=26) and non-glucocorticoids group (n=28) based on whether low-dose glucocorticoid treatment was used.The efficacy and treatment safety were analyzed and compared between the two groups. Results After 24 hours of hormone therapy, the oxygenation index and the change of vasoactive drug score (ΔVIS) in glucocorticoids group were significantly higher than those in non-glucocorticoids group (P<0.05). There were no statistically significant differences in median survival time, incidence rate of hospital infections, duration of mechanical ventilation, ICU and hospital stay between the two groups (P>0.05). The levels of interleukin (IL)-6, IL-10, Treg cell, CD4, and CD56 showed no significant differences between the two groups on the first and fifth day of ICU admission (all P>0.05). On the 5th day of admission at ICU, the levels of DCreg cell and CD8 in glucocorticoids group were significantly higher than those in non-glucocorticoids group (P<0.05). Conclusions Early use of low-dose glucocorticoids in the elderly patients with sepsis shock and immunosuppression can improve the oxygenation function and reduce the dosage of vasoactive drugs, without increasing the incidence of hospital infections and hospitalization stay.

Key words: glucocorticoids, sepsis shock, immunosuppression, prognosis