Perioperative medicine & outcomes
Perioperative Dexamethasone in Periprosthetic Joint Infection Surgery: Diabetes-Stratified Results From a Propensity Score–Matched Retrospective Cohort Study
Authors' conclusion
Further, findings suggest that dexamethasone is associated with lower odds of aggregate complications, and contrary to conventional wisdom, these benefits may be even greater among diabetics.
Study context
- Population
- Patients ≥18 years undergoing revision total joint arthroplasty (TJA) for hip or knee periprosthetic joint infection (PJI), 2015–2023, stratified by diabetes status1:1 matched
- Participants
- 61,527 patients
- Exposure
- Perioperative dexamethasone exposure vs no exposure
- Outcome
- Composite complications
Methodological detailspropensity score–matched, 1:1 matched, diabetes-stratified, all-payer US hospital-based dataset
- Propensity score–matched
- 1:1 matched
- Diabetes-stratified
- All-payer US hospital-based dataset
Main finding
As reported in the abstract
Composite (aggregate) complications by diabetes status
Dexamethasone vs No dexamethasoneAdjusted odds ratio (95% CI)
Nondiabetic cohort (n = 30,644 matched)
0.934(0.760–0.978)
Diabetic cohort (n = 14,996 matched)
0.814(0.746–0.889)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | |
|---|---|---|
| Wound complications (nondiabetic)Propensity-score matched | 0.891 (0.823–0.964) | |
| Wound complications (diabetic)Propensity-score matched | 0.879 (0.787–0.981) | |
| Infectious complications (nondiabetic)Propensity-score matched | 0.891 (0.823–0.964) | |
| Infectious complications (diabetic)Propensity-score matched | 0.827 (0.754–0.908) | |
| 0.512Adjusted odds ratio (log scale) |
Mortality (diabetic and nondiabetic)
- Statistically significant decrease in mortality in diabetic patients only
- aOR 0.692 (0.532-0.901) (95% CI)
- Propensity-score matched
Safety
| Outcome | aOR (95% CI) | |
|---|---|---|
| Wound complications by diabetes statusDexamethasone vs No dexamethasone · nondiabetic | 0.891 (0.823–0.964) | |
| Wound complications by diabetes statusDexamethasone vs No dexamethasone · diabetic | 0.879 (0.787–0.981) | |
| Infectious complications by diabetes statusDexamethasone vs No dexamethasone · nondiabetic | 0.891 (0.823–0.964) | |
| Infectious complications by diabetes statusDexamethasone vs No dexamethasone · diabetic | 0.827 (0.754–0.908) | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
Perioperative Dexamethasone in Periprosthetic Joint Infection Surgery: Diabetes-Stratified Results From a Propensity Score–Matched Retrospective Cohort Study. Anesth Analg. Published 27 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →