Association between chronic steroids and outcomes in hepatobiliary and pancreatic surgery - 17/06/23
Abstract |
Background |
Chronic steroid use has been associated with increased postoperative complication; however, the association between chronic steroids and hepatobiliary and pancreatic surgery through all aspects of disease etiologies and types of surgery performed remains an area of active research. Therefore, this study analyzed the association of chronic steroids use with outcomes after hepatobiliary and pancreatic surgery.
Methods |
The National Surgical Quality Improvement Program Participant Use Data Files for hepatobiliary and pancreatic surgeries performed between 2015 and 2019 were analyzed for chronic steroid use and postoperative adverse events.
Results |
A total of 54,382 patients underwent hepatobiliary or pancreatic surgery during the study period, of which 1672 (3.1%) were on chronic steroids. In patients undergoing pancreatic surgery, steroid use was associated with higher rates of pneumonia (odds ratio [OR] 1.3, 95% confidence interval [95% CI] 1.2–2.2), unplanned intubation (OR 1.2, 95% CI 1.1–2.3), readmission (OR 1.4, 95% CI 1.3–2.4), intraoperative or postoperative transfusions (OR 1.5, 95% CI 1.2–2.3), being more likely to remain on a ventilator for greater than 48 h (OR 1.4, 95% CI 1.2–1.9), and greater mortality (OR 1.2, 95% CI 1.1–3.1) when compared to those, not on chronic steroids. In patients undergoing hepatobiliary surgery, chronic steroid use was associated with higher rates of sepsis (OR 1.3, 95% CI 1.2–2.9), unplanned intubation (OR 1.4, 95% CI 1.2–2.7), intraoperative or postoperative transfusions (OR 1.5, 95% CI 1.3–2.3), and readmission (OR 1.2, 95% CI 1.0–1.9). There was no difference in pancreatic fistula rates or post-hepatectomy liver failure rates after pancreatic and hepatobiliary resections, respectively.
Conclusion |
Chronic steroids use was associated with higher rates of poor outcomes both perioperatively and postoperatively in pancreatic and hepatobiliary surgery. These results will allow clinicians to be better equipped to counsel patients on surgery's increased risks and establish various perioperative protocols for chronic steroid users.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Steroids were associated with higher rates of poor outcomes in patients undergoing pancreatic or hepatobiliary surgery. |
Keywords : NSQIP, Steroids, Hepatobiliary, Pancreas
Plan
Vol 226 - N° 1
P. 59-64 - juillet 2023 Retour au numéro
Article précédent
- Features of mixed medullary thyroid tumors: An NCDB analysis of clinicopathologic characteristics and survival
- Georgianna Sandilos, Johanna Lou, M. Virginia Butchy, John P. Gaughan, Lisa Reid, Francis R. Spitz, Toni Beninato, Maureen D. Moore
- Comparing carotid endarterectomies with or without shunting in symptomatic and asymptomatic patients
- Sara S. Soliman, Andrew Lazar, Noelle B. Millner, Kevin V. James, Rolando H. Rolandelli, Justin S. Roskam, Zoltan H. Nemeth
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?