Johanna Snäll1, Jyrki Törnwall2, Anna Liisa Suominen3,4, Hanna Thorén2. 1. Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00029, Helsinki, Finland. johanna.snall@helsinki.fi. 2. Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00029, Helsinki, Finland. 3. Institute of Dentistry, University of Eastern Finland, Kuopio, Finland. 4. Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.
Abstract
PURPOSE: We investigated leukocyte changes in facial fracture patients undergoing surgery. Of specific interest was the effect of perioperative dexamethasone on leukocyte changes. METHODS:Facial fracture patients were randomized to receive perioperatively a total dose of 30 mg of dexamethasone, whereas patients in the control group received no glucocorticoid. All patients received antibiotics until postoperative days 7-10. Leukocyte count was measured on postoperative days 1 and 2. Clinical infections were observed during the follow-up. RESULTS: A total of 110 adult patients were included in the study. Postoperative leukocytosis was found in 91.2% of patients receiving dexamethasone and in 67.9% of controls. Dexamethasone was associated strongly with leukocyte rise (p < 0.001) on both postoperative days. Transoral surgery and younger age (≤40 years) showed significant associations with leukocytosis on the first postoperative day (p = 0.002). In regression analyses, dexamethasone associated with leukocytosis most significantly (p < 0.001). No association was found with infections. CONCLUSIONS:Dexamethasone use was the most significant predictor of leukocyte rise. As a drug response, perioperative dexamethasone caused sixfold postoperative leukocytosis. High-dose dexamethasone-induced leukocytosis may confuse the clinical decision-making especially in assessment of early infections.
RCT Entities:
PURPOSE: We investigated leukocyte changes in facial fracturepatients undergoing surgery. Of specific interest was the effect of perioperative dexamethasone on leukocyte changes. METHODS:Facial fracturepatients were randomized to receive perioperatively a total dose of 30 mg of dexamethasone, whereas patients in the control group received no glucocorticoid. All patients received antibiotics until postoperative days 7-10. Leukocyte count was measured on postoperative days 1 and 2. Clinical infections were observed during the follow-up. RESULTS: A total of 110 adult patients were included in the study. Postoperative leukocytosis was found in 91.2% of patients receiving dexamethasone and in 67.9% of controls. Dexamethasone was associated strongly with leukocyte rise (p < 0.001) on both postoperative days. Transoral surgery and younger age (≤40 years) showed significant associations with leukocytosis on the first postoperative day (p = 0.002). In regression analyses, dexamethasone associated with leukocytosis most significantly (p < 0.001). No association was found with infections. CONCLUSIONS:Dexamethasone use was the most significant predictor of leukocyte rise. As a drug response, perioperative dexamethasone caused sixfold postoperative leukocytosis. High-dose dexamethasone-induced leukocytosis may confuse the clinical decision-making especially in assessment of early infections.
Authors: Eeva Kormi; Johanna Snäll; Anna-Maria Koivusalo; Anna Liisa Suominen; Hanna Thorén; Jyrki Törnwall Journal: J Oral Maxillofac Surg Date: 2016-09-26 Impact factor: 1.895
Authors: Gregory K Deirmengian; Benjamin Zmistowski; Christina Jacovides; Joseph O'Neil; Javad Parvizi Journal: Clin Orthop Relat Res Date: 2011-11 Impact factor: 4.176
Authors: Christine Tompkins; Alan Cheng; Jeffrey A Brinker; Joseph E Marine; Saman Nazarian; David D Spragg; Sunil Sinha; Henry Halperin; Gordon F Tomaselli; Ronald D Berger; Hugh Calkins; Charles A Henrikson Journal: Am J Cardiol Date: 2013-03-20 Impact factor: 2.778