Corticosteroids for aneurysmal subarachnoid haemorrhage and primary intracerebral haemorrhage
Key result
Corticosteroid therapy showed no evidence of beneficial or adverse effects on death or poor outcome in patients with SAH or PICH, with wide confidence intervals precluding definitive conclusions.
Why the study?
Does corticosteroid therapy reduce death or poor outcome in patients with subarachnoid haemorrhage or primary intracerebral haemorrhage?
Population
462 patients of any age and either gender with clinically diagnosed primary intracerebral haemorrhage or…
Comparison
Corticosteroid therapy vs Placebo or standard strategy arm
Design
Meta-analysis, Randomised or quasi-randomised clinical trials
Follow-up
1 to 6 months
Authors
Discussion
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Implication
Insufficient evidence precludes routine corticosteroid use in SAH or PICH; larger trials needed to resolve uncertainty.
Study Design
Type
Systematic Review (n=462)
Structured PICO
Does corticosteroid therapy reduce death or poor outcome in patients with subarachnoid haemorrhage or primary intracerebral haemorrhage?
P
Population
462 patients from 8 trials (256 with SAH and 206 with PICH) evaluating corticosteroid therapy versus placebo or standard care, followed for 1 to 6 months.
I
Intervention
Corticosteroid therapy (hydrocortisone, fludrocortisone acetate, or dexamethasone)
C
Comparator
Placebo or standard strategy arm
O
Outcome
Death and poor outcome (death, severe disability, or vegetative state) within the first one to six months of the event onsethard clinical
There is currently insufficient evidence to support or refute the use of corticosteroids for improving outcomes in patients with subarachnoid or primary intracerebral hemorrhage.
Limitations
- Studies differed substantially with regard to study populations, drugs, and methodological quality.
- Small sample sizes leading to wide confidence intervals.
- Small sample size
- Wide confidence intervals
- Studies differed substantially with regard to study populations, drugs, and methodological quality
Cite This Study
Feigin et al. (2005) conducted a systematic review in Subarachnoid haemorrhage and primary intracerebral haemorrhage (n=462). Corticosteroids vs. Placebo or standard strategy was evaluated on Death and poor outcome (death, severe disability, or vegetative state) within the first 1 to 6 months. Corticosteroid therapy showed no evidence of beneficial or adverse effects on death or poor outcome in patients with SAH or PICH, with wide confidence intervals precluding definitive conclusions.