Clinical evidence of growth hormone for patients undergoing abdominal surgery: Meta-analysis of randomized controlled trials

Table 1 Characteristics of studies included in meta-analysis comparing GH with placebo

Study	Year	Jadad score	Reference	Operation	GH
Lehner	1992	3	6	Gastrectomy or colectomy	0.15 IU/kg/d for 7 d
López	1993	1	7	Gastrointestinal surgery	24 IU/d for 5 d
Wong	1995	2	8	Laparoscopic cholecystectomy	12 IU/d for 5 d
Tacke	1994	1	9	Cholecystectomy	8 IU/d for 7 d
Saito	1992	3	10	Abdominal aortic aneurysm repair	0.3 IU/kg/d for 6 d
Kolstad	2001	5	11	Abdominal surgery	0.3 IU/kg/d for 5 d
Jensen	1998	5	12	Abdominal aortic aneurysm repair	0.3 IU/kg/d for 6 d
Ponting	1988	2	13	Ileoanal J-pouch surgery	12 IU/d for 6 d
Hammarqvist	1992	1	14	Cholecystectomy	8 IU/d for 7 d
Jiang	1989	4	15	Gastrectomy or colectomy	0.15 IU/kg/d for 7 d
Mjaaland	1991	3	16	Gastrointestinal surgery	24 IU/d for 5 d
Barle	2001	1	17	Laparoscopic cholecystectomy	12 IU/d for 5 d
Vara-Thorbeck 1	1993	3	18	Cholecystectomy	8 IU/d for 7 d
Barry 2	1998	4	19	Abdominal aortic aneurysm repair	0.3 IU/kg/d for 6 d
Liu	2001	5	20	Abdominal surgery	0.3 IU/kg/d for 5 d
Barry 1	1999	3	21	Abdominal aortic aneurysm repair	0.3 IU/kg/d for 6 d
Kissmeyer-Nielsen	1999	5	22	Ileoanal J-pouch surgery	12 IU/d for 6 d
Vara-Thorbeck 2	1996	3	23	Cholecystectomy	8 IU/d for 7 d

Table 2 Random effect model of standardized mean difference (95%CI) in improving postoperative nitrogen balance (A) and in reducing the duration of postoperative fatigue syndrome (C) and weighted mean difference (95%CI) in decreasing the length of hospital stay (B) and in increasing blood glucose levels (D) with GH as compared with placebo

Study	Treatment	Treatment	Control	Control	Weight	SMD (random)
	n	Mean (SD)	n	Mean (SD)	%	95%CI
Ponting	6	1.8 (0.40)	5	-0.90 (0.70)	6.23	4.46 [1.85, 7.07]
Jiang	9	-7.10 (3.12)	9	-32.60 (4.20)	6.27	6.56 [3.97, 9.16]
Mjaaland	9	4.1 (1.10)	10	-3.10 (1.80)	8.36	4.55 [2.69, 6.41]
Hammarqvist	8	-2.32 (1.66)	9	-7.09 (0.71)	8.91	3.63 [1.94, 5.32]
Lehner	19	-4.30 (9.60)	21	-14.80 (3.30)	11.94	1.46 [0.76, 2.17]
Saito	18	-18.00 (3.30)	18	-185.00 (58.00)	10.6	3.98 [2.80, 5.15]
López	9	-7.30 (2.80)	9	-20.70 (4.10)	9.09	3.64 [2.00, 5.27]
Tacke	9	-10.00 (2.61)	10	-20.47 (3.86)	9.85	3 [1.60, 4.40]
Wong	8	3 (0.90)	7	-1.30 (0.75)	7.15	4.85 [2.59, 7.11]
Jenson	9	-47 (20.00)	10	-73.00 (20.00)	11.12	1.24 [0.24, 2.25]
Kolstad	11	-3.90 (0.40)	10	-5.70 (0.90)	10.49	2.53 [1.32, 3.73]
Total (95%CI)	115		118		100	3.37 [2.46, 4.27]

Test for heterogeneity: χ² = 44.48, df = 10 (P < 0.00001), I² = 77.5%. Test for overall effect: Z = 7.27 (P < 0.00001).

Table 3 Random effect model of standardized mean difference (95%CI) in improving postoperative nitrogen balance (A) and in reducing the duration of postoperative fatigue syndrome (C) and weighted mean difference (95%CI) in decreasing the length of hospital stay (B) and in increasing blood glucose levels (D) with GH as compared with placebo

Study	Treatment	Treatment	Control	Control	Weight	WMD (fixed)
	n	Mean (SD)	n	Mean (SD)	%	95%CI
Barry 2	8	13 (2.00)	10	17.00 (3.00)	17.05	-4 [-6.32, -1.68]
Liu	10	9.7 (1.80)	10	10.50 (1.30)	48.41	-0.8 [-2.18, 0.58]
Vara-Thorbeck 1	87	9.6 (3.60)	93	12.50 (7.10)	34.54	-2.9 [-4.53, -1.27]
Total (95%CI)	105		113		100	-2.07 [-3.03, -1.11]

Test for heterogeneity: χ² = 6.93, df = 2 (P = 0.03), I² = 71.1%. Test for overall effect: Z = 4.24 (P < 0.0001).

Table 4 Random effect model of standardized mean difference (95%CI) in improving postoperative nitrogen balance (A) and in reducing the duration of postoperative fatigue syndrome (C) and weighted mean difference (95%CI) in decreasing the length of hospital stay (B) and in increasing blood glucose levels (D) with GH as compared with placebo

Study	Treatment	Treatment	Control	Control	Weight	SMD (fixed)
	n	Mean (SD)	n	Mean (SD)	%	95%CI
Barry 1	7	1.6 (1.20)	10	4.90 (2.20)	21.23	-1.68 [-2.84, -0.52]
Kissmeyer-Nielsen	9	1.37 (0.55)	10	2.73 (2.00)	31.57	-0.86 [-1.82, 0.09]
Vara-Thorbeck 2	22	1.52 (0.43)	26	3.14 (0.75)	47.2	-2.55 [-3.33, -1.77]
Total (95%CI)	38		46		100	-1.83 [-2.37, -1.30]

Test for heterogeneity: χ² = 7.32, df = 2 (P = 0.03), I² = 72.7%. Test for overall effect: Z = 6.72 (P < 0.00001).

Table 5 Random effect model of standardized mean difference (95%CI) in improving postoperative nitrogen balance (A) and in reducing the duration of postoperative fatigue syndrome (C) and weighted mean difference (95%CI) in decreasing the length of hospital stay (B) and in increasing blood glucose levels (D) with GH as compared with placebo

Study	Treatment	Treatment	Control	Control	Weight	WMD (random)
	n	Mean (SD)	n	Mean (SD)	%	95%CI
Barle	10	6.4 (1.00)	10	5.40 (0.50)	11.98	1 [0.31, 1.69]
Hammarqvist	8	5.6 (0.30)	9	4.80 (0.20)	20.69	0.8 [0.55, 1.05]
Jiang	9	6.17 (0.51)	9	6.06 (0.50)	16.26	0.11 [-0.36, 0.58]
Mjaaland	9	5.75 (0.43)	10	4.90 (0.30)	18.94	0.85 [0.51, 1.19]
Ponting	6	9.4 (0.70)	5	7.20 (0.50)	11.68	2.2 [1.49, 2.91]
Vara-Thorbeck 1	87	6.56 (1.02)	93	5.66 (0.71)	20.46	0.9 [0.64, 1.16]
Total (95%CI)	129		136		100	0.91 [0.56, 1.25]

Test for heterogeneity: χ² = 23.97, df = 5 (P = 0.0002), I² = 79.1%. Test for overall effect: Z = 5.13 (P < 0.00001).