Cardiothoracic & vascular anesthesia
The Effects of Dexamethasone in Cardiac Surgery: A Registry-Based, Real-World Data Analysis of Clinical Outcomes From the Netherlands Heart Registration
Main finding · Composite clinical outcomeResult — go to the resultOdds ratio 0.82 95% CI 0.72–0.92Authors' conclusion
Prophylactic dexamethasone during adult cardiac surgery was associated with reduced composite clinical outcomes, renal failure, and shorter hospital stays, and seemed associated with 30-day mortality in patients >80 years old.
Study context
- Population
- Elective and urgent on-pump cardiac surgery patients, Netherlands Heart Registration, 2013–2021
- Participants
- 54,694 participants
- Exposure
- Perioperative dexamethasone vs no dexamethasone
- Dexamethasonen = 40,891
- Outcome
- 30-day mortality and a composite of 30-day mortality, in-hospital stroke, and 30-day renal or respiratory failure
- Follow-up
- 30 days
Methodological detailspopulation-based, registry-based, propensity score matching
- Population-based
- Registry-based
- Propensity score matching
Main finding
Composite clinical outcome
Odds ratio
0.82
95% CI 0.72–0.92
P < 0.001
Dexamethasone vs No dexamethasone
OR 0.82 (95% CI 0.72–0.92); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Renal failure · 30 daysPropensity score matched | 0.57 (0.47–0.70) | P < 0.001 | |
| 30-day mortality (subgroup: patients >80 years) | 1.52 (1.01–2.28) | P = 0.044 | |
| 0.512Odds ratio (log scale) |
Hospital LOS
- Significantly shorter hospital LOS with dexamethasone (B, 95% CI)
- B −0.17, 95% CI, −0.32 to −0.02, P = .025
- Propensity score matched
Other components of the composite outcome and other secondary outcomes
- No significant association with dexamethasone use
Other demographic and clinical subgroups (subgroup)
- Observed benefits consistent across other subgroups
Clinical practice variation (national survey of Dutch cardiac anesthesiologists)
- Substantial variability in dexamethasone use across centers and anesthesiologists
Original publication
The Effects of Dexamethasone in Cardiac Surgery: A Registry-Based, Real-World Data Analysis of Clinical Outcomes From the Netherlands Heart Registration. Anesth Analg. Published 8 May 2025. doi:10.
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