Perioperative medicine & outcomes
Association Between Intraoperative Dexamethasone and Postoperative Mortality in Patients Undergoing Oncologic Surgery: A Multicentric Cohort Study
Authors' conclusion
Dexamethasone is associated with decreased 1-year mortality and cancer recurrence in patients undergoing surgical resection of cancers that are not candidates for immune modulators. Dexamethasone increased the risk of postoperative hyperglycemia, however, no increase in surgical site infections was identified.
Study context
- Population
- Adults undergoing solid cancer resection, 2005–2020
- Participants
- 30,561 adults
- Exposure
- Intraoperative dexamethasone vs no dexamethasone
- Dexamethasonen = 11,666
- Outcome
- Mortality and recurrence-free survival
- Follow-up
- 1 year
Methodological detailsmultivariable logistic regression, interaction term analysis
- Multivariable logistic regression
- Interaction term analysis
Main finding
As reported in the abstract
1-year mortality
Each group vs no dexamethasoneRisk reduction (95% CI)P value
Dexamethasone
−0.6%(−1.1 to −0.2)
P = 0.007Each group vs no dexamethasoneEstimate (95% CI)P value
Dexamethasone
aOR 0.79(0.67–0.94)
P = 0.009Dexamethasone
HR 0.82(0.69–0.96)
P = 0.016- Overall 1-year mortality
- 3.2%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Recurrence-free survival · 1 yearHigher odds of recurrence-free survival | aOR for recurrence-free survival (higher = better) 1.28 (CI 1.18–1.39) | P < 0.001 | |
| 1-year mortality, cancers not responsive to checkpoint inhibitor therapy (subgroup)Effect modification by interaction term analysis | aOR for death 0.70 (CI 0.57–0.87) | P = 0.001 | |
| 1-year mortality, cancers responsive to checkpoint inhibitor therapy (subgroup)Effect modification by interaction term analysis | aOR for death 1.13 (CI 0.85–1.50) | P = 0.40 | |
| 0.512Ratio (log scale) |
Safety
| Outcome | aOR (CI) | P value | |
|---|---|---|---|
| Hyperglycemia >180 mg/dL within 24 h (high dose >0.09 mg/kg) · high (>0.09 mg/kg) dose | 1.55 (1.32–1.82) | P < 0.001 | |
| Surgical site infections within 30 days (high dose >0.09 mg/kg)High (>0.09 mg/kg) dose | 0.84 (0.42–1.71) | P = 0.63 | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
Association Between Intraoperative Dexamethasone and Postoperative Mortality in Patients Undergoing Oncologic Surgery: A Multicentric Cohort Study. Ann Surg. Published 18 July 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →