Low-dose corticosteroids in cirrhotic patients with septic shock or vasopressor-dependent shock: A systematic review and meta-analysis
Pooled resultResult — go to the resultRelative risk 0.99 95 % CI 0.86–1.13Authors' conclusion
Low-dose corticosteroids in cirrhotic patients with septic or vasopressor-dependent distributive shock show limited benefit, as improved shock resolution and reduced shock-related mortality did not translate into in-hospital survival and may increase the risk of severe adverse events.
Study context
- Population
- Cirrhotic patients with septic shock or other vasopressor-dependent distributive shock
- Participants
- 514 patients · 2 randomized controlled trials (RCTs) · 4 observational cohorts
- Comparison
- Low-dose corticosteroids vs control
- Outcome
- In-hospital mortality
Pooled result
As reported in the abstract
Relative risk
0.99
95 % CI 0.86–1.13
P = 0.832
Corticosteroids vs Control
RR 0.99 (95 % CI 0.86–1.13); P = 0.832
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Refractory shock-related mortalityI2 = 0 %; reduced with corticosteroids | 0.16 (0.06–0.41) | P < 0.001 | |
| 0.050.21520Relative risk (log scale) |
Vasopressor-free days
- No benefit observed in vasopressor-free days
- 2.06 (MD; 95 % CI −0.86 to 4.99; p = 0.166; I2 = 58.6 %)
Safety
Gastrointestinal bleeding
- Adverse events higher for gastrointestinal bleeding
- 2.73 (RR; 95 % CI 1.15-6.52; p = 0.023; I2 = 0 %)
New organ failure
- Adverse events higher for new organ failure
- 1.42 (RR; 95 % CI 1.01-1.99; p = 0.045; I2 = 0 %)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Low-dose corticosteroids in cirrhotic patients with septic shock or vasopressor-dependent shock: A systematic review and meta-analysis. J Crit Care. Published 17 December 2025. doi:10.
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