Butler E, Møller MH, Cook O, et al. - By analyzing data from relevant randomised clinical trials, researchers investigated how the incidence of gastrointestinal bleeding in adult critically ill patients is altered by the use of systemic corticosteroids. They analyzed trials comparing systemic corticosteroids, vs placebo/no treatment, given for more than 24 h in adult critically ill patients. The incidence of clinically important gastrointestinal bleeding within 90 days (primary outcome) and the incidence of gastrointestinal bleeding of any severity within 90 days (secondary outcome) were assessed as the outcomes of interest. The primary outcome was described in 25 trials with 14,615 participants, and secondary outcome in 55 trials involving 21,792 participants. In the corticosteroid group and in the control group, the estimated pooled incidence of clinically significant gastrointestinal bleeding was 2.3% and 1.8%, respectively. Among adult critically ill patients, an overall low incidence of clinically important gastrointestinal bleeding was reported. A slight rise in the incidence of clinically important gastrointestinal bleeding but not bleeding of any severity may be induced by corticosteroids.