Summary of findings for the main comparison. Recombinant human growth hormone compared with placebo for treating burns and donor sites.
| Recombinant human growth hormone compared with placebo for treating burns and donor sites | ||||||
| Patient or population: Settings: burn centres Intervention: recombinant human growth hormone Comparison: | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Recombinant human growth hormone | ||||||
| Healing time of burn wounds in days for adults | The mean healing time of burn wounds in days for adults in the intervention groups was 9.07 lower (4.39 to 13.76 lower) |
36 (2 studies) | ⊕⊕⊝⊝ low1,2,3,4 | |||
| Donor site healing time in days for adults | The mean donor site healing time in days for adults in the intervention groups was 3.15 lower (1.54 to 4.75 lower) | 36 (2 studies) | ⊕⊕⊝⊝ low1,2,3,4 | |||
| Donor site healing time in days for children | The mean donor site healing time in days for children in the intervention groups was 1.70 lower (0.87 to 2.53 lower) | 73 (2 studies) |
⊕⊕⊝⊝ low13 | |||
| Mortality in adults and children | Study population5 | RR 0.53 (0.22 to 1.29) | 324 (5 studies) | ⊕⊕⊝⊝ low5,6,7 | ||
| 7 per 100 | 4 per 100 (2 to 9) | |||||
| Low5 | ||||||
| 5 per 100 | 3 per 100 (1 to 6) | |||||
| High5 | ||||||
| 13 per 100 | 7 per 100 (3 to 17) | |||||
| Septicaemia in adults | Study population8 | RR 0.61 (0.31 to 1.22) | 267 (4 studies) | ⊕⊕⊝⊝ low1,8,9 | ||
| 13 per 100 | 8 per 100 (4 to 16) | |||||
| Low8 | ||||||
| 4 per 100 | 2 per 100 (1 to 5) | |||||
| High8 | ||||||
| 13 per 100 | 8 per 100 (4 to 16) | |||||
| Hyperglycaemia in adults and children | Study population10 | RR 2.65 (1.68 to 4.16) | 340 (5 studies) | ⊕⊕⊝⊝ low2,10,11 | ||
| 11 per 100 | 30 per 100 (19 to 48) | |||||
| Low10 | ||||||
| 0 per 100 | 0 per 100 (0 to 0) | |||||
| High10 | ||||||
| 19 per 100 | 50 per 100 (32 to 79) | |||||
| Length of hospital stay in days for adults | The mean length of hospital stay in days for adults in the intervention groups was 12.55 lower (8 to 17.09 lower) | 99 (4 studies) | ⊕⊕⊝⊝ low1,12 | |||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Method of randomisation, allocation concealment and blinding not reported. 2 Small sample sizes of studies and wide confidence interval of estimate. 3 Patients in study of Sun 1998 had larger and deeper burns. 4 In the studies of Sun 1998 and Luo 2000 the way of assessment of the healing time was not reported. 5 The low and high risk values are the two extreme numbers of mortality in the control groups from two studies. 6 Method of randomisation and blinding in four studies and allocation concealment in five studies not reported. 7 Mortality is a rare outcome and the number of included patients in three studies was small. 8 The low and high risk values are the two extreme numbers of septicaemia in the control groups from two studies. 9 Septicaemia is a rare outcome and the number of included patients in three studies was small. 10 The low and high risk values are the two extreme numbers of hyperglycaemia in the control groups from two studies. Small sample sizes in four studies and wide confidence interval of estimate. 11 Method of randomisation and blinding in three studies and allocation concealment in five studies not reported. 12 Small sample sizes in four studies and wide confidence interval of estimate. Patients in control group of study of Lu 2004 received glutamine orally and no placebo injections. 13 Method of randomisation in one study and allocation concealment in two studies not reported.