Corticosteroids lowered short-term mortality but increased high blood sugar in pooled critical-care trials
In critically ill patients with specified severe infections or lung conditions, corticosteroids reduced short-term deaths compared with placebo. High blood sugar was more frequent, while infection and bleeding differences remained unclear.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Across randomized trials in these critically ill patient groups, corticosteroids reduced short-term mortality compared with placebo. Several measures of hospital recovery also favored treatment, but high blood sugar occurred more often. Infection and gastrointestinal bleeding did not show statistically significant differences. The pooled findings describe these clinical populations and do not establish a preferred regimen for every patient.
The abstract reports relative effects without absolute death counts. It also combines different critical illnesses and treatment regimens, limiting what the overall estimate can say about a particular patient's expected benefit or harm.
What researchers found
Death by 28 days or nearest reported assessment
Versus placebo: relative risk 0.85, 95% confidence interval 0.77–0.94. This is a relative risk estimate; the abstract does not report the absolute mortality difference.
Benefit and harm were assessed separately
Shorter intensive-care and hospital stays and less time on mechanical ventilation accompanied the mortality finding. Higher blood sugar was a separate adverse outcome, so the review does not support describing treatment as uniformly beneficial.
Unclear differences are not confirmed safety
The infection and gastrointestinal bleeding comparisons were not statistically significant. That does not demonstrate identical safety. Subgroup findings about timing, dose, or combinations also cannot establish which regimen is best without a clear direct comparison.
The original publication
Efficacy and safety of corticosteroids in critically ill patients: a systematic review and meta-analysis.
Cao L, Xiang Y, Wu Z et al.
BMC Anesthesiol · 2025
- PubMed ID
- 40597594
- Record checked
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