Table 2.
Selection of Trials | N Trials | N Patients | Estimate of Effect | Heterogeneity | |||
---|---|---|---|---|---|---|---|
RoM | 95% CI | p | I 2 | p | |||
All | 17 | 1967 | 0.835 | 0.81–0.86 | 10−26 | 90% | 10−24 |
Exclusion1 (a) | 16 | 1882 | 0.908 | 0.87–0.94 | 10−6 | 58% | 0.002 |
Exclusion2 (a) | 15 | 1842 | 0.923 | 0.89–0.96 | 0.00003 | 35% | 0.088 |
Final meta-analysis (b) | 12 | 1766 | 0.922 | 0.89–0.96 | 0.00003 | 43% | 0.055 |
Sensitivity analysis (c) | 9 | 1312 | 0.927 | 0.88–0.98 | 0.005 | 51% | 0.036 |
Cardiac trials | 11 | 1726 | 0.918 | 0.88–0.95 | 0.00001 | 43% | 0.066 |
Oral vitamin C | 6 | 927 | 0.914 | 0.86–0.97 | 0.003 | 49% | 0.08 |
Intravenous vitamin C | 6 | 839 | 0.928 | 0.88–0.97 | 0.003 | 47% | 0.10 |
Trials in Iran | 6 | 862 | 0.927 | 0.88–0.98 | 0.005 | 43% | 0.12 |
Trials out of Iran | 6 | 904 | 0.917 | 0.87–0.97 | 0.002 | 53% | 0.06 |
1-2 days ICU (d) | 7 | 1231 | 0.943 | 0.89–0.99 | 0.027 | 52% | 0.05 |
3-5 days ICU (d) | 5 | 535 | 0.899 | 0.85–0.95 | 0.0001 | 23% | 0.3 |
(a) Exclusion1 is the meta-analysis in which the Dingchao trial [106] is excluded. Exclusion2 is the meta-analysis in which the Abdoulhossein study vitamin E patients [122] is further excluded. (b) The final meta-analysis excludes the three small trials by Colby [109], Fowler [115], and Zabet [117] in addition to the two trials excluded in Exclusion2. Note that the exclusion of these three small trials has no meaningful effect on the point estimate of effect (RoM: 0.9227 versus 0.9220) or on the p-value, but their exclusion increases the level of heterogeneity from I2 = 35% to 43%. The Final meta-analysis, indicated by bold, is shown as Figure 3. The subgroup analyses below the final meta-analysis are based on the final meta-analysis. (c) In the sensitivity analysis, we excluded two trials with no description of allocation [114,118], and a quasi-randomized trial [121]. (d) Length of ICU stay in the control group of the trial; see the comparison of the subgroups in Supplementary file S1. Abbreviations: RoM, ratio of means; for example, RoM = 0.922 of the final model indicates that vitamin C shortens the mean length of ICU stay by 7.8%.