Steroids play life saving role in Sepsis, finds JAMA study
China: Steroids play a life-saving role in Sepsis by improving health care outcomes including more shock reversals. Administration of corticosteroids in sepsis patients significantly leads to a reduction in 28-day mortality compared with standard supportive care or placebo use, according to a new study published in the journal JAMA Internal Medicine.
Sepsis, a life-threatening condition caused by the body’s response to an infection, is one of the most frequent causes of death in the hospital and one of the most expensive conditions to treat. It affects an estimated 15–19 million cases per year worldwide. It is the third leading cause of death worldwide and the main cause of mortality in hospitals.
Although corticosteroids are widely used for adults with sepsis, both the overall benefit and potential risks remain unclear. To shed light on the same, Fang Fang, West China Hospital, Sichuan University, Chengdu, Sichuan, China, and colleagues conducted this systematic review and meta-analysis of 37 randomized clinical trials involving 9564 patients with sepsis to test the efficacy and safety of corticosteroids in patients with sepsis.
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- Corticosteroid use was associated with reduced 28-day mortality and intensive care unit (ICU) mortality and in-hospital mortality.
- Corticosteroids were significantly associated with increased shock reversal at day 7 and vasopressor-free days and with ICU length of stay, the sequential organ failure assessment score at day 7, and time to resolution of shock.
- However, corticosteroid use was associated with an increased risk of hyperglycemia and hypernatremia.
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"The findings suggest that administration of corticosteroids is associated with reduced 28-day mortality compared with placebo use or standard supportive care. More research is needed to associate personalized medicine with the corticosteroid treatment to select suitable patients who are more likely to show a benefit," concluded the authors.
For further reference log on to 10.1001/jamainternmed.2018.5849