In this meta-analysis of 37 RCTs (including 9564 patients), corticosteroid treatment was significantly associated with reduced 28-day mortality, ICU mortality, and in-hospital mortality among patients with sepsis. However, this survival benefit was not replicated with 90-day mortality.

Subgroup analyses based on treatment modalities demonstrated that the beneficial effect in 28-day mortality was associated with the use of low-dose corticosteroids. The association with 28-day mortality was not observed with high-dose corticosteroids.

However, meta-regression did not demonstrate a credible association for any of the subgroup differences.

His meta-analysis showed that the use of corticosteroids in sepsis was associated with a significant increase in shock reversal and vasopressor-free days to day 28 and with a marked decrease in ICU length of stay, SOFA score at 7 days, and time to resolution of shock.

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