Perioperative medicine & outcomes
The Association of Guideline-Directed Prophylaxis With Postoperative Nausea and Vomiting in Adult Patients: A Single-Center, Retrospective Cohort Study
Authors' conclusion
Guideline-directed PONV prophylaxis is associated with a modest reduction in PONV, although this effect is small and heterogeneous on the absolute scale.
Study context
- Population
- Adult patients undergoing GA, 2018 to 202143% adequate prophylaxis
- Participants
- 76,703 patients
- Exposure
- Adequate postoperative nausea and vomiting (PONV) prophylaxis vs not adequate
- Outcome
- PONV (documented PONV or receipt of rescue antiemetics)
Methodological detailssingle-centre, overlap propensity score weighting, Bayesian binomial models
- Single-centre
- Overlap propensity score weighting
- Bayesian binomial models
Main finding
As reported in the abstract
PONV
Adequate prophylaxisEstimate (CrI)
After propensity score weighting and multivariable adjustment
weighted marginal median OR 0.90(0.84–0.98)
PONV
ARR 1.6%(0.6%–2.6%)
- PONV incidence overall
- 19%
Observational data: associations, not effects.
Further findings
PONV, unadjusted and unweighted
| Median OR (95% CrI) | ||
|---|---|---|
| Adequate prophylaxis95% CrI | 1.21 (1.16–1.25) | |
| 0.512Median odds ratio (log scale) |
PONV by number of risk factors (subgroup)
- Benefit in patients with 1 to 5 risk factors (conditional probabilities of benefit)
- >0.81
- No benefit in those at high predicted risk
Patient-specific covariate-adjusted absolute risk reduction (ARR)
- Median patient-specific conditional probability of benefit
- 0.84 (95% CrI 0.73-0.90)
- Heterogeneous
Original publication
The Association of Guideline-Directed Prophylaxis With Postoperative Nausea and Vomiting in Adult Patients: A Single-Center, Retrospective Cohort Study. Anesth Analg. Published 31 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →