Cardiac arrest & resuscitation
Efficacy and safety of corticosteroids in cardiac arrest: a systematic review, meta-analysis and trial sequential analysis of randomized control trials
Pooled result · MortalityResult — go to the resultRelative risk 0.96 95% CI 0.90–1.02Authors' conclusion
In patients during or after cardiac arrest, corticosteroids have an uncertain effect on mortality but probably increase ROSC and may increase the likelihood of survival with good functional outcome at hospital discharge.
Study context
- Population
- Patients following in- and out-of-hospital cardiac arrest
- Participants
- 2,213 patients · 8 randomized controlled trials (RCTs)
- Comparison
- Corticosteroids vs placebo or usual care
- Outcome
- Mortality at the longest point of follow-up
- Follow-up
- Longest point
Methodological detailsrandom effects meta-analysis, trial sequential analysis, GRADE certainty of evidence
- Random effects meta-analysis
- Trial sequential analysis
- GRADE certainty of evidence
Pooled result
Mortality
Relative risk
0.96
95% CI 0.90–1.02
Corticosteroids vs Placebo or usual care
RR 0.96 (95% CI 0.90–1.02)
As reported in the abstract
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| ROSCModerate certainty | RR for ROSC 1.32 (95% CI 1.18–1.47) | |
| Survival with good functional outcomeLow certainty | RR for survival with good functional outcome 1.49 (95% CI 0.87–2.54) | |
| 0.20.5125Ratio (log scale) |
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| VAPLow certainty | 0.76 (0.46–1.09) | |
| Renal failureLow certainty | 1.29 (0.84–1.99) | |
| BleedingVery low certainty | 2.04 (0.53–7.84) | |
| PeritonitisVery low certainty | 10.54 (2.99–37.19) | |
| 0.050.21520Relative risk (log scale) |
Original publication
Efficacy and safety of corticosteroids in cardiac arrest: a systematic review, meta-analysis and trial sequential analysis of randomized control trials. Crit Care. Published 11 January 2023. doi:10.
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