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. 2013 Jun 4;2013(6):CD004878. doi: 10.1002/14651858.CD004878.pub4

Comparison 1. Glucocorticoid versus placebo.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Admissions (days 1 and 7) (outpatients) ‐ review primary outcome 10   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
1.1 Admissions day 1 10 1762 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.78, 1.08]
1.2 Admissions day 7 6 1530 Risk Ratio (M‐H, Random, 95% CI) 0.86 [0.70, 1.06]
2 Length of stay (inpatients) ‐ review primary outcome 8 633 Mean Difference (IV, Random, 95% CI) ‐0.18 [‐0.39, 0.04]
3 Length of stay (outpatients) 3 255 Mean Difference (IV, Random, 95% CI) 0.10 [‐0.81, 1.01]
4 Clinical scores (outpatients) 11   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
4.1 60 minutes 6 1006 Std. Mean Difference (IV, Random, 95% CI) ‐0.04 [‐0.16, 0.09]
4.2 120 minutes 5 214 Std. Mean Difference (IV, Random, 95% CI) ‐0.17 [‐0.55, 0.21]
4.3 3 to 6 hours 5 808 Std. Mean Difference (IV, Random, 95% CI) ‐0.14 [‐0.50, 0.21]
4.4 12 to 24 hours 2 69 Std. Mean Difference (IV, Random, 95% CI) 0.13 [‐0.51, 0.76]
4.5 3 to 10 days 5 224 Std. Mean Difference (IV, Random, 95% CI) ‐0.20 [‐0.61, 0.21]
5 Clinical scores (inpatients) 4   Std. Mean Difference (Random, 95% CI) Subtotals only
5.1 3 to 6 hours 1 174 Std. Mean Difference (Random, 95% CI) ‐1.03 [‐1.87, ‐0.19]
5.2 6 to 12 hours 3 269 Std. Mean Difference (Random, 95% CI) ‐0.62 [‐1.00, ‐0.23]
5.3 12 to 24 hours 3 264 Std. Mean Difference (Random, 95% CI) ‐0.28 [‐0.66, 0.09]
5.4 24 to 72 hours 4 271 Std. Mean Difference (Random, 95% CI) ‐0.53 [‐1.14, 0.08]
6 O2 saturation (outpatients) 8   Mean Difference (IV, Random, 95% CI) Subtotals only
6.1 60 minutes 5 936 Mean Difference (IV, Random, 95% CI) ‐0.27 [‐0.73, 0.19]
6.2 120 minutes 2 75 Mean Difference (IV, Random, 95% CI) ‐0.10 [‐1.56, 1.37]
6.3 3 to 6 hours 5 808 Mean Difference (IV, Random, 95% CI) ‐0.43 [‐0.84, ‐0.02]
6.4 24 to 72 hours 1 38 Mean Difference (IV, Random, 95% CI) 0.20 [‐1.01, 1.41]
7 O2 saturation (inpatients) 2   Mean Difference (IV, Random, 95% CI) Subtotals only
7.1 6 to 12 hours 1 67 Mean Difference (IV, Random, 95% CI) ‐0.7 [‐1.98, 0.58]
7.2 12 to 24 hours 2 116 Mean Difference (IV, Random, 95% CI) ‐0.44 [‐2.04, 1.16]
7.3 24 to 72 hours 1 67 Mean Difference (IV, Random, 95% CI) 1.10 [‐0.77, 2.97]
8 Respiratory rate (outpatients) 8   Mean Difference (IV, Random, 95% CI) Subtotals only
8.1 60 minutes 3 861 Mean Difference (IV, Random, 95% CI) ‐0.24 [‐1.51, 1.03]
8.2 120 minutes 2 69 Mean Difference (IV, Random, 95% CI) ‐1.95 [‐9.30, 5.39]
8.3 3 to 6 hours 3 733 Mean Difference (IV, Random, 95% CI) ‐1.12 [‐3.07, 0.82]
8.4 12 to 24 hours 2 69 Mean Difference (IV, Random, 95% CI) 0.15 [‐7.10, 7.40]
8.5 3 to 10 days 4 174 Mean Difference (IV, Random, 95% CI) ‐1.64 [‐7.89, 4.61]
9 Respiratory rate (inpatients) 2   Mean Difference (IV, Random, 95% CI) Subtotals only
9.1 6 to 12 hours 1 66 Mean Difference (IV, Random, 95% CI) ‐4.0 [‐11.45, 3.45]
9.2 12 to 24 hours 2 110 Mean Difference (IV, Random, 95% CI) ‐1.22 [‐5.08, 2.64]
9.3 24 to 72 hours 1 28 Mean Difference (IV, Random, 95% CI) ‐1.90 [‐15.37, 11.57]
10 Heart rate (outpatients) 9   Mean Difference (IV, Random, 95% CI) Subtotals only
10.1 60 minutes 5 936 Mean Difference (IV, Random, 95% CI) 0.46 [‐1.62, 2.55]
10.2 120 minutes 4 144 Mean Difference (IV, Random, 95% CI) ‐3.54 [‐8.83, 1.75]
10.3 3 to 6 hours 5 808 Mean Difference (IV, Random, 95% CI) ‐0.65 [‐7.01, 5.71]
10.4 12 to 24 hours 2 69 Mean Difference (IV, Random, 95% CI) 1.85 [‐11.18, 14.88]
10.5 3 to 10 days 3 136 Mean Difference (IV, Random, 95% CI) 0.43 [‐8.32, 9.18]
11 Heart rate (inpatients) 1   Mean Difference (IV, Random, 95% CI) Subtotals only
11.1 12 to 24 hours 1 49 Mean Difference (IV, Random, 95% CI) ‐9.0 [‐18.99, 0.99]
12 Hospital readmissions (inpatients) 3   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
12.1 2 to 10 days 1 67 Risk Ratio (M‐H, Random, 95% CI) 3.66 [0.43, 31.03]
12.2 10 to 30 days 2 292 Risk Ratio (M‐H, Random, 95% CI) 0.41 [0.11, 1.53]
13 Return healthcare visits (inpatients) 3   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
13.1 2 to 10 days 1 67 Risk Ratio (M‐H, Random, 95% CI) 1.10 [0.86, 1.42]
13.2 10 to 30 days 2 292 Risk Ratio (M‐H, Random, 95% CI) 1.21 [0.30, 4.96]
14 Return healthcare visits (outpatients) 3   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
14.1 10 to 30 days 3 863 Risk Ratio (M‐H, Random, 95% CI) 1.04 [0.80, 1.35]
15 Admissions at day 1 (outpatients) ‐ subgroup analysis protocolised use of bronchodilator 10 1762 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.78, 1.08]
15.1 Protocolised use of bronchodilator 7 717 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.56, 1.29]
15.2 No protocolised use of bronchodilator 3 1045 Risk Ratio (M‐H, Random, 95% CI) 0.94 [0.79, 1.13]
16 Admissions within 7 days (outpatients) ‐ subgroup analysis protocolised use of bronchodilator 6 1530 Risk Ratio (M‐H, Random, 95% CI) 0.86 [0.70, 1.06]
16.1 Protocolised use of bronchodilator 4 581 Risk Ratio (M‐H, Random, 95% CI) 0.68 [0.44, 1.05]
16.2 No protocolised use of bronchodilator 2 949 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.82, 1.11]
17 Admissions at day 1 (outpatients) ‐ subgroup analysis age 10 1762 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.78, 1.08]
17.1 All < 12 months 3 1397 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.79, 1.10]
17.2 Including > 12 months 7 365 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.51, 1.49]
18 Admissions within 7 days (outpatients) ‐ subgroup analysis age 6 1530 Risk Ratio (M‐H, Random, 95% CI) 0.86 [0.70, 1.06]
18.1 All < 12 months 3 1346 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.80, 1.06]
18.2 Including > 12 months 3 184 Risk Ratio (M‐H, Random, 95% CI) 0.67 [0.25, 1.83]
19 Length of stay (inpatients) ‐ subgroup analysis protocolised use of bronchodilator 8 633 Mean Difference (IV, Random, 95% CI) ‐0.18 [‐0.39, 0.04]
19.1 Protocolised use of bronchodilator 4 206 Mean Difference (IV, Random, 95% CI) ‐0.12 [‐0.23, ‐0.00]
19.2 No protocolised use of bronchodilator 4 427 Mean Difference (IV, Random, 95% CI) ‐0.31 [‐0.83, 0.20]
20 Length of stay (inpatients) ‐ subgroup analysis age 8 633 Mean Difference (IV, Random, 95% CI) ‐0.18 [‐0.39, 0.04]
20.1 All < 12 months 4 314 Mean Difference (IV, Random, 95% CI) ‐0.10 [‐0.65, 0.45]
20.2 Including > 12 months 4 319 Mean Difference (IV, Random, 95% CI) ‐0.21 [‐0.53, 0.12]
21 Length of stay (inpatients) ‐ subgroup analysis RSV status 8 633 Mean Difference (IV, Random, 95% CI) ‐0.18 [‐0.39, 0.04]
21.1 All RSV‐positive 3 251 Mean Difference (IV, Random, 95% CI) ‐0.09 [‐0.63, 0.45]
21.2 Not all RSV‐positive, or NR 5 382 Mean Difference (IV, Random, 95% CI) ‐0.20 [‐0.57, 0.17]
22 Admissions (days 1 and 7) (outpatients) ‐ sensitivity analysis with only low overall RoB 3   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
22.1 Admissions day 1 3 1397 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.79, 1.10]
22.2 Admissions day 7 3 1346 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.80, 1.06]
23 Length of stay (inpatients) ‐ sensitivity analysis with only low overall RoB 1 67 Mean Difference (IV, Random, 95% CI) 0.38 [‐0.46, 1.21]