Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis
ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Emb...
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2021
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oai:doaj.org-article:bdc1e7fc56784ec881ec9adcc368c5412021-11-05T15:20:13ZCorticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis1664-322410.3389/fimmu.2021.709155https://doaj.org/article/bdc1e7fc56784ec881ec9adcc368c5412021-08-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.709155/fullhttps://doaj.org/toc/1664-3224ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (>60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdfHuoyan LiangHuoyan LiangHeng SongHeng SongRuiqing ZhaiGaofei SongGaofei SongHongyi LiHongyi LiXianfei DingQuancheng KanTongwen SunTongwen SunFrontiers Media S.A.articlecorticosteroidssepsismortalitymeta-analysissystematic reviewImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021) |
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EN |
| topic |
corticosteroids sepsis mortality meta-analysis systematic review Immunologic diseases. Allergy RC581-607 |
| spellingShingle |
corticosteroids sepsis mortality meta-analysis systematic review Immunologic diseases. Allergy RC581-607 Huoyan Liang Huoyan Liang Heng Song Heng Song Ruiqing Zhai Gaofei Song Gaofei Song Hongyi Li Hongyi Li Xianfei Ding Quancheng Kan Tongwen Sun Tongwen Sun Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis |
| description |
ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (>60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdf |
| format |
article |
| author |
Huoyan Liang Huoyan Liang Heng Song Heng Song Ruiqing Zhai Gaofei Song Gaofei Song Hongyi Li Hongyi Li Xianfei Ding Quancheng Kan Tongwen Sun Tongwen Sun |
| author_facet |
Huoyan Liang Huoyan Liang Heng Song Heng Song Ruiqing Zhai Gaofei Song Gaofei Song Hongyi Li Hongyi Li Xianfei Ding Quancheng Kan Tongwen Sun Tongwen Sun |
| author_sort |
Huoyan Liang |
| title |
Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis |
| title_short |
Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis |
| title_full |
Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis |
| title_fullStr |
Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis |
| title_full_unstemmed |
Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis |
| title_sort |
corticosteroids for treating sepsis in adult patients: a systematic review and meta-analysis |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/bdc1e7fc56784ec881ec9adcc368c541 |
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