Cardiothoracic & vascular anesthesia
Impact of Prophylactic Corticosteroid Use on In-hospital Mortality and Respiratory Failure After Esophagectomy for Esophageal Cancer: Nationwide Inpatient Data Study in Japan
Main finding · In-hospital mortalityResult — go to the resultOdds ratio 0.80 95% CI 0.69–0.93Authors' conclusion
Prophylactic corticosteroid use in oncologic esophagectomy was associated with lower in-hospital mortality as well as decreased respiratory failure and severe respiratory failure
Study context
- Population
- Patients undergoing oncologic esophagectomy, Japanese nationwide inpatient database, July 2010–March 2019
- Participants
- 35,501 eligible patients
- Exposure
- Prophylactic corticosteroids vs no corticosteroids before esophagectomy
- Corticosteroidsn = 22,620
- Outcome
- In-hospital mortality and respiratory failure
Methodological detailsnationwide inpatient database, stabilized inverse probability of treatment weighting, propensity score matching, instrumental variable analysis
- Nationwide inpatient database
- Stabilized inverse probability of treatment weighting
- Propensity score matching
- Instrumental variable analysis
Main finding
In-hospital mortality
Odds ratio
0.80
95% CI 0.69–0.93
Corticosteroids vs No corticosteroids
OR 0.80 (95% CI 0.69–0.93)
As reported in the abstract
- In-hospital mortality, overall cohort
- 924 (2.6%)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Respiratory failureStabilized IPTW analysis | 0.84 (0.79–0.90) | |
| Severe respiratory failureStabilized IPTW analysis | 0.87 (0.80–0.95) | |
| 0.512Odds ratio (log scale) |
- Respiratory failure — Respiratory failure, overall cohort
- 5440 (15.3%)
- Severe respiratory failure — Severe respiratory failure, overall cohort
- 2861 (8.1%)
Postoperative LOS and total hospitalization costs
- Decreased with corticosteroids
Propensity score matching and instrumental variable analyses (sensitivity analyses)
- Similar results
Safety
Anastomotic leakage
- Proportion did not differ with corticosteroid use
Original publication
Impact of Prophylactic Corticosteroid Use on In-hospital Mortality and Respiratory Failure After Esophagectomy for Esophageal Cancer: Nationwide Inpatient Data Study in Japan. Ann Surg. Published 14 July 2022. doi:10.
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