Impact on Efficacy and Safety of Hydrocortisone in Sepsis and Septic Shock – A Systematic Literature Review and Meta-analysis

Background: Sepsis and septic shock are major causes of morbidity and mortality worldwide, associated with a high economic and social burden on healthcare systems and communities, yet with few definite treatment modalities. The efficacy of steroids in the management of sepsis or septic shock remains...

Full description

Saved in:

Bibliographic Details
Published in:	Archives of Iranian medicine Vol. 22; no. 7; p. 394
Main Authors:	Aletreby, Waleed Tharwat, Alharthy, Abdulrahman Mishaal, Ahmed Fouad Madi, Ibrahim Refaat Soliman, Hend Mohammed Hamido, Omar Elsayed Ramadan, Alzayer, Wasim, Basim Mohammed Huwait, Mohammed Ali Alodat, Shahzad Ahmed Mumtaz, Nasir Nasim Mahmood, Mahmoud Hussien Al Kurdi, Farrag, Hazem Abdulgaffar, Karakitsos, Dimitrios
Format:	Journal Article
Language:	English
Published:	Tehran Academy of Medical Sciences of I.R. Iran 01-07-2019
Subjects:	Clinical outcomes Drug therapy Literature reviews Meta-analysis Mortality Sepsis Steroids Systematic review
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Background: Sepsis and septic shock are major causes of morbidity and mortality worldwide, associated with a high economic and social burden on healthcare systems and communities, yet with few definite treatment modalities. The efficacy of steroids in the management of sepsis or septic shock remains a controversy and subject of investigation due to their theoretical beneficial effects. Methods: This was a systematic literature review and meta-analysis on randomized controlled trials of hydrocortisone usage in sepsis or septic shock as of 2000, following the GRADE methodology, considering a primary outcome of 28 day all-cause mortality. Results: Ten randomized control trials were included in the review, 9 of which reported 28 day mortality either as a primary or secondary outcome. Relative risk of dying at 28 days was 0.93 in favor of hydrocortisone (95% CI: 0.86–1.01; P = 0.056). Other secondary outcomes of the review were similarly statistically insignificant. The quality of evidence was graded as very low to low. Conclusion: Hydrocortisone, when used in sepsis or septic shock, in critically ill adult patients showed a statistically insignificant trend towards decreasing 28 day all-cause mortality. This warrants consideration of clinical significance for each patient individually.
ISSN:	1029-2977 1735-3947