Corticosteroid therapy for severe acute pancreatitis: a meta-analysis of randomized, controlled trials.
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.


CONCLUSIONS
Corticosteroid therapy may improve outcomes in patients with SAP.
Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China ; Intensive Care Unit, Second Affiliated Hospital of Jilin University Changchun 130041, China.
Li-Hua
LH
Dong
Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China.
Zhong-Min
ZM
Liu
Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China.
Shi-Ji
SJ
Wang
Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China.
Shu-Jie
SJ
Zhao
Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China.
Dong
D
Zhang
Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China.
Ying
Y
Chen
Intensive Care Unit, First Affiliated Hospital of Jilin University Changchun 130021, China.
Yu-Shan
YS
Wang
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D016001:Confidence Intervals; D006801:Humans; D007902:Length of Stay; D016017:Odds Ratio; D010195:Pancreatitis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
D000305:Adrenal Cortex Hormones
Corticosteroid; meta-analysis; severe acute pancreatitis