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 5.1 software. Results: A total of eight articles with 184 cases in this treatment group and 177 participants 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.