The Systematic Review and Meta-Analysis of the Efficacy of Granulocyte-Colony Stimulating Factor (G-CSF) in Treatment of Sepsis and Septic Shock

Context: There are conflicting results in the literature regarding the effect of granulocyte-colony stimulating factor (G-CSF) on the outcomes of sepsis and septic shock patients hospitalized in the intensive care unit (ICU). Objectives: The present meta-analysis aims to investigate the efficacy of G-CSF in the treatment of sepsis and septic shock. Methods: Studies were selected using a systematic search in the EMBASE and PubMed databases, conducted in September 2024 over one month. Studies from 1996 to 2023 were selected based on inclusion criteria. Outcomes included mortality rate, APACHE II scores, sequential organ failure assessment (SOFA) scores, and ICU stay length. Exclusion criteria included pediatric and prophylactic studies. Meta-analysis was performed using Review Manager V.5.1 software. Results: Fourteen randomized controlled trial (RCT) studies were selected based on the inclusion criteria. The results of this meta-analysis indicated no significant effect of G-CSF administration on mortality rate [0.62 (1.14 - 0.34), Z = 1.53, P = 0.130], SOFA scores [-0.64 (-1.09 - 1.09), Z = 1.48, P = 0.14], and ICU stay length [-3.46 (-40.79 - 40.79), Z = 0.42, P = 0.68]. However, G-CSF administration was associated with a significant decrease in APACHE II scores [-2.25 [-4.36 - (-0.14)], Z = 2.09, P = 0.04]. Conclusions: It was concluded that the administration of G-CSF as an adjunctive treatment to patients with sepsis and septic shock does not affect mortality rate, dysfunction of vital organs, or the length of stay in the ICU.