SynthesisIntensive care medicine2019
The effect of systemic corticosteroids on the incidence of gastrointestinal bleeding in critically ill adults: a systematic review with meta-analysis.
Synthesis in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 38 citations in OpenAlex.
- The Acute Respiratory Distress Syndrome (ARDS): epidemiology, etiology, molecular mechanisms, diagnosis and therapeutic strategies.Molecular biomedicine · 2026Review
- Corticosteroids in asthma and COPD: an inflammopharmacological perspective on molecular and genetic determinants.Molecular biology reports · 2026Review
- Potentially inappropriate prescriptions in acutely admitted older patients: a development study to create a clinical decision support tool using a Delphi process.European geriatric medicine · 2026Article
- Phlorizin-integrated magnetic pollen micromotors for diabetes complication management.Materials today. Bio · 2025Article
- Neurosarcoidosis in Critical Care, Internal, and Pulmonary Medicine: A Practical Approach.Seminars in respiratory and critical care medicine · 2025Review
- Risk Factors for Patient-Important Upper Gastrointestinal Bleeding.American journal of respiratory and critical care medicine · 2025Article
- Risk factors for gastrointestinal complications during glucocorticoid therapy in internal medicine inpatients: a real-world retrospective analysis.BMC pharmacology & toxicology · 2025Article
- Curable giant hematoma due to small bowel mesenteric laceration after screening colonoscopy: a case report.Annals of medicine and surgery (2012) · 2025Article
- Safe Use of Corticosteroids in Non-Infectious Uveitis.Journal of inflammation research · 2025Review
- The Use of Proton Pump Inhibitors in Patients with Liver Cirrhosis: Real Life Experience.Journal of clinical medicine · 2024Article
- Thinking Three-Dimensionally: A Self- and Externally-Controlled Approach to Screening for Drug-Drug-Drug Interactions Among High-Risk Populations.Clinical pharmacology and therapeutics · 2024Article
- Low-Dose Corticosteroids for Critically Ill Adults With Severe Pulmonary Infections: A Review.JAMA · 2024Review
- Effects of 12 mg vs. 6 mg dexamethasone on thromboembolism and bleeding in patients with critical COVID-19 - a post hoc analysis of the randomized, blinded COVID STEROID 2 trial.Annals of intensive care · 2023Article
- Risk factors of active upper gastrointestinal bleeding in patients with COVID-19 infection and the effectiveness of PPI prophylaxis.BMC gastroenterology · 2022Article
- Trends of Readmissions for Gastrointestinal Bleeding After Alcoholic Hepatitis: Analysis of the Nationwide Readmission Database.Gastroenterology research · 2022Article
- Gastrointestinal bleeding in critically ill immunocompromised patients.Annals of intensive care · 2021Article
- Massive intraperitoneal hemorrhage in patients with COVID-19: a case series.Journal of thrombosis and thrombolysis · 2021Article
- Underutilization of gastrointestinal prophylaxis in high-risk chronic nonsteroidal anti-inflammatory drug users in Korea.International journal of clinical pharmacy · 2021Article
- Effect of different corticosteroid regimes for hospitalised patients with exacerbated COPD: pooled analysis of individual participant data from the REDUCE and CORTICO-COP trials.Respiratory research · 2021Article
- Focus on gastrointestinal system in critically ill patients.Intensive care medicine · 2020Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the effect of systemic corticosteroids on the incidence of gastrointestinal bleeding in adult critically ill patients.
methodsWe systematically reviewed randomised clinical trials comparing systemic corticosteroids administered for more than 24 h with placebo/no treatment in adult critically ill patients. Trial selection, data abstraction and risk of bias assessments were performed in duplicate. We used trial sequential analysis (TSA) to assess the risk of random errors and the grading of recommendations, assessment, development, and evaluations (GRADE) approach to assess the quality of evidence. The primary outcome was the incidence of clinically important gastrointestinal bleeding within 90 days. The secondary outcome was the incidence of gastrointestinal bleeding of any severity within 90 days.
resultsTwenty-five trials (n = 14,615) reported data for the primary outcome and 55 trials (n = 21,792) for the secondary outcome. The pooled incidence of clinically important gastrointestinal bleeding was 2.3% in the corticosteroid group and 1.8% in the control group (RR, 1.26; 95% CI, 1.01-1.57; I
conclusionsWe observed an overall low incidence of clinically important gastrointestinal bleeding among adult critically ill patients. Corticosteroids may slightly increase the incidence of clinically important gastrointestinal bleeding, but not bleeding of any severity. Rarity of events, infrequent trial reporting and high risk of bias reduced the quality of evidence.
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