Effect of early goal-directed therapy on mortality in patients with severe sepsis or septic shock：a Meta analysis
10.3760/cma.j.issn.2095-4352.2015.09.007
- VernacularTitle:早期目标导向治疗对严重脓毒症或脓毒性休克患者病死率影响的Meta分析
- Author:
Xing LU
;
Tong LI
;
Jun LI
;
Xinjing GAO
;
Lei XU
- Publication Type:Journal Article
- Keywords:
Severe sepsis;
Septic shock;
Bundle;
Early goal-directed therapy;
Mortality
- From:
Chinese Critical Care Medicine
2015;(9):735-738
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate whether early goal-directed therapy (EGDT) could improve the mortality rate in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed, Cochrane Library, Embase data, Wanfang data, and CNKI from January 1980 to May 2015. Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT), clinical controlled trial (CCT), case-control studies, cohort studies with complete data, which endpoints were the short-term mortality [in-hospital, intensive care unit (ICU) or 28-day] and long-term mortality (60-day, 90-day or 1 year). RevMan 5.2 software was used for Meta analysis of effect of EGDT on mortality rate in patients with severe sepsis or septic shock, and funnel plot was drawn to evaluate the quality of enrolled literature.Results There were 12 studies meeting inclusive criteria including 5 528 patients, 4 RCTs, 3 case-control studies, 4 cohort studies, and 1 quasi-experimental research. It was shown by Meta analysis that EGDT was associated with significant decrease in the short-term mortality [relative risk (RR) = 0.72, 95% confidence interval (95%CI) = 0.64-0.80,P< 0.000 01], but not associated with decrease of long-term mortality (RR = 0.99, 95%CI = 0.92-1.06,P = 0.81). The funnel plot showed that there was no publication bias. EGDT was recommended as grade C.Conclusions EGDT was associated with significant improvement in short-term mortality but not with long-term mortality in patients with severe sepsis or septic shock. Grade C was recommended by our study.
