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Article

Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis

  • Authors:
    • Qing Zhao
    • Jia‑Xin Shi
    • Rong Hu
    • Qin Li
    • Chen‑Ying Zhang
    • Jia‑Shu Li
  • View Affiliations / Copyright

    Affiliations: Outpatient Department, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu 222002, P.R. China, Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu 222002, P.R. China
  • Pages: 4913-4920
    |
    Published online on: October 31, 2019
       https://doi.org/10.3892/etm.2019.8156
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Abstract

To date, the efficacy of glucocorticoid therapy to reduce mortality in patients with acute respiratory distress syndrome (ARDS) has remained controversial among the studies available. The present meta‑analysis study aimed to further clarify the impact of glucocorticoid therapy on mortality in patients with ARDS by performing a pooled analysis of the previous data. The PubMed, Chinese Knowledge Infrastructure, Wanfang and Cochrane trials databases were searched for relevant studies published between 1966 and 2016. Randomized controlled trials (RCTs) that included the use of glucocorticoids in patients with ARDS and had reported on mortality were included. Odds ratios (OR) and 95% confidence intervals (CI) for mortality were calculated. A total of 10 RCTs were included in the meta‑analysis. Of these, 4 studies used high‑dose glucocorticoid therapy, while 6 used low‑dose glucocorticoid therapy. In the pooled analysis, glucocorticoids were indicated to significantly reduce ARDS‑associated mortality (OR=0.64, 95% CI: 0.48‑0.85, P=0.002). Further subgroup analysis indicated the following: i) Long‑term low‑dose glucocorticoid therapy reduced ARDS‑associated mortality compared with that in the control group (OR=0.60, 95% CI: 0.44‑0.82, P=0.001), whereas high‑dose short‑term glucocorticoid therapy did not reduce mortality (OR=0.82, 95% CI: 0.43‑1.57, P=0.55). ii) Early initiation of glucocorticoid therapy was associated with reduced mortality compared with that in the control group (OR=0.60, 95% CI: 0.44‑0.83, P=0.002); however, late initiation did not reduce mortality (OR=0.36, 95% CI: 0.03‑3.76, P=0.39). iii) Therapeutic rather than preventive use of glucocorticoids reduced mortality (OR=0.65, 95% CI: 0.49‑0.86, P=0.003). Overall, the present meta‑analysis suggests that early initiation of long‑term low‑dose glucocorticoid therapy reduces mortality of patients with ARDS.
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Copy and paste a formatted citation
Spandidos Publications style
Zhao Q, Shi JX, Hu R, Li Q, Zhang CY and Li JS: Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis. Exp Ther Med 18: 4913-4920, 2019.
APA
Zhao, Q., Shi, J., Hu, R., Li, Q., Zhang, C., & Li, J. (2019). Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis. Experimental and Therapeutic Medicine, 18, 4913-4920. https://doi.org/10.3892/etm.2019.8156
MLA
Zhao, Q., Shi, J., Hu, R., Li, Q., Zhang, C., Li, J."Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis". Experimental and Therapeutic Medicine 18.6 (2019): 4913-4920.
Chicago
Zhao, Q., Shi, J., Hu, R., Li, Q., Zhang, C., Li, J."Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis". Experimental and Therapeutic Medicine 18, no. 6 (2019): 4913-4920. https://doi.org/10.3892/etm.2019.8156
Copy and paste a formatted citation
x
Spandidos Publications style
Zhao Q, Shi JX, Hu R, Li Q, Zhang CY and Li JS: Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis. Exp Ther Med 18: 4913-4920, 2019.
APA
Zhao, Q., Shi, J., Hu, R., Li, Q., Zhang, C., & Li, J. (2019). Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis. Experimental and Therapeutic Medicine, 18, 4913-4920. https://doi.org/10.3892/etm.2019.8156
MLA
Zhao, Q., Shi, J., Hu, R., Li, Q., Zhang, C., Li, J."Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis". Experimental and Therapeutic Medicine 18.6 (2019): 4913-4920.
Chicago
Zhao, Q., Shi, J., Hu, R., Li, Q., Zhang, C., Li, J."Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta‑analysis". Experimental and Therapeutic Medicine 18, no. 6 (2019): 4913-4920. https://doi.org/10.3892/etm.2019.8156
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