Efficacy and safety of corticosteroid therapy in patients with cardiac arrest: A meta-analysis of randomized controlled trials

作者全名："Zhou, Fa-Wei; Liu, Chang; Li, De-Zhong; Zhang, Yong; Zhou, Fa-Chun"

作者地址："[Zhou, Fa-Wei; Liu, Chang; Zhou, Fa-Chun] Chongqing Med Univ, Dept Emergency, Affiliated Hosp 1, Chongqing, Peoples R China; [Zhou, Fa-Wei; Li, De-Zhong] Cent Hosp Enshi Tujia & Miao Autonomous Prefecture, Dept Emergency, Enshi, Peoples R China; [Zhang, Yong] Jianli Peoples Hosp, Dept Nephrol, Jianli, Peoples R China"

通信作者："Zhou, FC (通讯作者)，Chongqing Med Univ, Dept Emergency, Affiliated Hosp 1, Chongqing, Peoples R China.; Zhang, Y (通讯作者)，Jianli Peoples Hosp, Dept Nephrol, Jianli, Peoples R China."

来源：AMERICAN JOURNAL OF EMERGENCY MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001110159600001

JCR分区：Q1

影响因子：3.6

年份：2024

卷号：75

期号：　

开始页：111

结束页：118

文献类型：Article

关键词：Steroid; Corticosteroid; Cardiac arrest; Survival; Systematic review; Meta-analysis

摘要："Background: The clinical benefits of steroid therapy during cardiac arrest (CA) are unclear. Several recent clinical trials have shown that administering corticosteroid therapy during CA may improve patient outcomes. The purpose of the present study was to determine whether providing corticosteroids improves outcomes for patients following CA.Methods: We searched the PubMed, Embase, Cochrane Library, Web of Science and CNKI databases for randomized controlled trials comparing corticosteroid therapy to placebo during CA.Results: Eleven relevant studies involving a total of 2273 patients were included in the meta-analysis. The statistical analysis showed that corticosteroid treatment during CA was significantly associated with an increased rate of sustained return of spontaneous circulation (ROSC) (OR: 2.05, 95% CI: 1.24 to 3.37, P < 0.01). Corticosteroid treatment during CA did not show a significant benefit in favorable neurological outcomes (OR: 1.13, 95% CI: 0.81 to 1.58, P = 0.49) or overall survival rate at hospital discharge (OR: 1.29, 95% CI: 0.74 to 2.26, P = 0.38). However, in the subgroup analysis, we found that patients had a significantly increased survival rate and ROSC if the dose of corticosteroid therapy above 100 mg methylprednisolone. The statistical analysis revealed no significant differences in adverse events.Conclusion: High-dose corticosteroid treatment (above 100 mg methylprednisolone) is associated with better overall survival rate at hospital discharge and ROSC outcomes. However, there is uncertainty regarding whether this treatment results in a benefit or harm to the favorable neurological outcomes at hospital discharge.(c) 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/)."

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