Summary of findings 2. Corticosteroids versus placebo compared for preventing critical illness polyneuropathy and critical illness myopathy.
| Corticosteroids versus placebo compared to for | ||||||
| Patient or population: critically ill patients Settings: medical or surgical ICU Intervention: corticosteroids versus placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Corticosteroids | |||||
| Occurrence of CIP/CIM ‐ in total population randomised | 231 per 1000 | 293 per 1000 (178 to 480) | RR 1.27 (0.77 to 2.08) | 180 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| Occurrence of CIP/CIM ‐ in screened population | 229 per 1000 | 250 per 1000 (121 to 518) | RR 1.09 (0.53 to 2.26) | 92 (1 study) | ⊕⊕⊕⊝ moderate2 | |
| Death ‐ death at 180 days in total population randomised | 319 per 1000 | 315 per 1000 (204 to 484) | RR 0.99 (0.64 to 1.52) | 180 (1 study) | ⊕⊕⊕⊕ high | |
| Serious adverse events (dichotomous data) ‐ shock | 165 per 1000 | 68 per 1000 (28 to 166) | RR 0.41 (0.17 to 1.01) | 180 (1 study) | ⊕⊕⊕⊕ high | |
| Serious adverse events (dichotomous data) ‐ serious infection | 330 per 1000 | 224 per 1000 (138 to 366) | RR 0.68 (0.42 to 1.11) | 180 (1 study) | ⊕⊕⊕⊕ high | |
| Serious adverse events (dichotomous data) ‐ suspected or probable pneumonia | 154 per 1000 | 68 per 1000 (28 to 168) | RR 0.44 (0.18 to 1.09) | 180 (1 study) | ⊕⊕⊕⊕ high | |
| Serious adverse events (continuous data) ‐ blood glucose (mg/dL) on day 7 | The mean blood glucose on day 7 in the intervention groups was 15 mg/dL higher (3.41 lower to 33.41 higher) | 180 (1 study) | ⊕⊕⊕⊕ high | |||
| *The basis for the assumed risk (eg 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; ICU: intensive care unit; 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 Imputation of a substantial amount of data. 2 No clear diagnostic criteria for CIP/CIM stated.