Cochrane · systematic review · CD005566
Prophylactic corticosteroids for cardiopulmonary bypass in adult cardiac surgery
Abbasciano, RG, Olivieri, GM, Chubsey, R, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
HeartAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 14.3%Low 6 · 85.7%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Prophylactic corticosteroids compared with placebo or no corticosteroids in adults undergoing cardiac surgery with cardiopulmonary bypass
Population: adults diagnosed with coronary artery disease or cardiac valve disease, and candidates for cardiac surgery with cardiopulmonary bypass
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (during the index hospital admission, or within 30 days, at the longest Prophylactic corticosteroids vs placebo or no corticosteroids | RR 0.9 [0.75, 1.07] | 25 studies · 14940 participants | Low Downgraded: risk of bias, imprecision |
Cardiac complications (as defined by study authors, including cardiac compromise and fatal and non‐fatal myocardial infarction, defined as ECG changes, echocardiological changes, or disproportionate elevation of troponins, during the index hospita... Prophylactic corticosteroids vs placebo or no corticosteroids | RR 1.16 [1.04, 1.31] | 25 studies · 14766 participants | Low Downgraded: risk of bias, inconsistency, indirectness |
Pulmonary complications (as defined by study authors, including pneumonia, embolism, reduced pulmonary function, prolonged ventilation, and pleural effusion, during the index hospital admission) Prophylactic corticosteroids vs placebo or no corticosteroids | RR 0.88 [0.78, 0.99] | 18 studies · 13549 participants | Low Downgraded: risk of bias, inconsistency, indirectness |
Infectious complications (as defined by study authors, including mediastinitis, wound infections, pneumonia, and need for antibiotic therapy, during the index hospital admission) Prophylactic corticosteroids vs placebo or no corticosteroids | RR 0.84 [0.76, 0.92] | 28 studies · 14771 participants | Low Downgraded: risk of bias, inconsistency |
Gastrointestinal (GI) bleeding (as defined by study authors, including any upper and lower GI bleeding, during the index hospital admission) Prophylactic corticosteroids vs placebo or no corticosteroids | RR 1.21 [0.87, 1.67] | 6 studies · 12533 participants | Low Downgraded: imprecision |
Renal failure (as defined by study authors, including dialysis, creatinine rise, and oliguria, during the index hospital admission) Prophylactic corticosteroids vs placebo or no corticosteroids | RR 0.84 [0.69, 1.02] | 13 studies · 12799 participants | Low Downgraded: risk of bias, imprecision |
Length of hospital stay (measured in days, during the index hospital admission) Prophylactic corticosteroids vs placebo or no corticosteroids | no estimate extracted | 25 studies · 1841 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |