Li-Hua Dong1, Zhong-Min Liu2, Shi-Ji Wang2, Shu-Jie Zhao2, Dong Zhang2, Ying Chen2, Yu-Shan Wang2. 1. Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China ; Intensive Care Unit, Second Affiliated Hospital of Jilin University Changchun 130041, China. 2. Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China.
Abstract
BACKGROUND: Recent reports about the benefits of corticosteroid therapy in patients with severe acute pancreatitis (SAP) have shown conflicting results. We aimed to explore the effects of corticosteroid therapy in SAP patients on patient outcomes by performing a meta-analysis. METHODS: Databases (Medline, EMBASE, Web of Science, PubMed, Cochrane Library, Chinese Biomedicine Database, and China Academic Journal Full-Text Database) were queried for all relevant, randomized, controlled trials investigating corticosteroid therapy in patients with SAP. RESULTS: Six randomized, controlled trials including 430 SAP patients were identified. Corticosteroid therapy for SAP was associated with reductions in the length of hospital stay, the need for surgical intervention, and the mortality rate (weighted mean difference [WMD]: -9.47, 95% confidence interval [CI]: -16.91 to -2.04, P = 0.01; odds ratio [OR]: 0.35, 95% CI: 0.18-0.67, P = 0.002; OR: 0.45, 95% CI: 0.22-0.94, P = 0.03). There were no significant differences in the complication rates or Physiology and Chronic Health Evaluation II (APACHE II) scores in patients with or without corticosteroid therapy. CONCLUSION: Corticosteroid therapy may improve outcomes in patients with SAP.
BACKGROUND: Recent reports about the benefits of corticosteroid therapy in patients with severe acute pancreatitis (SAP) have shown conflicting results. We aimed to explore the effects of corticosteroid therapy in SAP patients on patient outcomes by performing a meta-analysis. METHODS: Databases (Medline, EMBASE, Web of Science, PubMed, Cochrane Library, Chinese Biomedicine Database, and China Academic Journal Full-Text Database) were queried for all relevant, randomized, controlled trials investigating corticosteroid therapy in patients with SAP. RESULTS: Six randomized, controlled trials including 430 SAP patients were identified. Corticosteroid therapy for SAP was associated with reductions in the length of hospital stay, the need for surgical intervention, and the mortality rate (weighted mean difference [WMD]: -9.47, 95% confidence interval [CI]: -16.91 to -2.04, P = 0.01; odds ratio [OR]: 0.35, 95% CI: 0.18-0.67, P = 0.002; OR: 0.45, 95% CI: 0.22-0.94, P = 0.03). There were no significant differences in the complication rates or Physiology and Chronic Health Evaluation II (APACHE II) scores in patients with or without corticosteroid therapy. CONCLUSION: Corticosteroid therapy may improve outcomes in patients with SAP.
Entities:
Keywords:
Corticosteroid; meta-analysis; severe acute pancreatitis
Authors: J Schölmerich; C Schümichen; M Lausen; V Gross; H G Leser; L Lay; E H Farthmann; W Gerok Journal: Dig Dis Sci Date: 1991-01 Impact factor: 3.199
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