Efficacy of glucocorticoids for treatment of severe acute pancreatitis: a meta analysis

Abstract

Objective To evaluate the efficacy of glucocorticoids in treatment of patients with severe acute pancreatitis(SAP).Methods According to the inclusion criteria,the experimental design,characteristics of the included objects,and the corresponding outcomes were extracted from relevant literatures.Meta-analysis was done to evaluate the results by RevMan 5.1software.Results A total of eight articles with 184cases in this treatment group and 177participants in the control group were included in this meta-analysis.Data from six studies showed that the mortality rate of glucocorticoid group(14/145,9. 655%)was significantly lower than that of the control group(28/139,20.14%),with the difference being statistically significant(OR=0.42,95% CI[0.21-0.83],P=0.01).Data from three studies showed that the frequency of acute respiratory distress syndrome(ARDS)of the glucocorticoid group(20/95,21.05%)was significantly lower than that of the control group(37/89,41.57%,OR=0.33,95% CI[0.16-0.65],P=0.001).Data from three studies showed that the operation transferring rate in the glucocorticoid group(12/87,13.79%)was significantly lower than that of control group(26/ 81,32.09%,OR=0.29,95% CI[0.13-0.67],P=0.004).Compared with the control group,the glucocorticoid group also had significantly reduced the mean hospital stay in four experiments(standardized mean difference-1.52,95% CI[-2.73--0.32],P=0.01).Conclusion Glucocorticoid has advantages over conventional treatments in reducing the incidence of ARDS and mortality and shortening hospital stay in SAP patients,which provides a new and prospective therapeutic option for SAP.