Hassan Aziz1, Zubair Ahmed2, Mohamed Abdimajid2, Yurie Sekigami2, Martin Hertl2, Martin D Goodman2. 1. Tufts Medical Center, Tufts University School of Medicine, South Building, Floor 4, 860 Washington St, Boston, MA, 02111, USA. haziz@tuftsmedicalcenter.org. 2. Tufts Medical Center, Tufts University School of Medicine, South Building, Floor 4, 860 Washington St, Boston, MA, 02111, USA.
Abstract
BACKGROUND: A national study analyzing the association between preoperative steroid use and outcomes after pancreatic resections is lacking. The purpose of this study is to evaluate the association between preoperative steroids and outcomes after pancreaticoduodenectomy using a national database. MATERIALS AND METHODS: A retrospective analysis of patients undergoing pancreaticoduodenectomy was performed using the National Surgical Quality Improvement Program (NSQIP) database (2014-2019). In addition, we utilized propensity score matching to compare patients on preoperative steroids to those who were not. Outcomes measured included 30-day complications and mortality, need for readmission, a prolonged hospital length of stay, delayed gastric emptying, and pancreatic fistula. RESULTS: After propensity score matching, there were 438 patients in the steroid group and 876 patients in the no steroid group. There was no difference in pancreatic fistula (23.8% vs. 21.7%; p-0.3), delayed gastric emptying (21.1% vs.20.1%; p-0.06), major complications (31.8% vs. 30.1%; p-0.1), and mortality (3.5% vs. 3.2%; p-0.6) between the two groups. CONCLUSION: Glucocorticoids did not reduce the incidence of overall complications, postoperative fistula, and delayed gastric emptying following pancreaticoduodenectomy.
BACKGROUND: A national study analyzing the association between preoperative steroid use and outcomes after pancreatic resections is lacking. The purpose of this study is to evaluate the association between preoperative steroids and outcomes after pancreaticoduodenectomy using a national database. MATERIALS AND METHODS: A retrospective analysis of patients undergoing pancreaticoduodenectomy was performed using the National Surgical Quality Improvement Program (NSQIP) database (2014-2019). In addition, we utilized propensity score matching to compare patients on preoperative steroids to those who were not. Outcomes measured included 30-day complications and mortality, need for readmission, a prolonged hospital length of stay, delayed gastric emptying, and pancreatic fistula. RESULTS: After propensity score matching, there were 438 patients in the steroid group and 876 patients in the no steroid group. There was no difference in pancreatic fistula (23.8% vs. 21.7%; p-0.3), delayed gastric emptying (21.1% vs.20.1%; p-0.06), major complications (31.8% vs. 30.1%; p-0.1), and mortality (3.5% vs. 3.2%; p-0.6) between the two groups. CONCLUSION: Glucocorticoids did not reduce the incidence of overall complications, postoperative fistula, and delayed gastric emptying following pancreaticoduodenectomy.
Authors: Marta Sandini; Katarina J Ruscic; Cristina R Ferrone; Andrew L Warshaw; Motaz Qadan; Matthias Eikermann; Keith D Lillemoe; Carlos Fernández-Del Castillo Journal: Ann Surg Oncol Date: 2018-10-08 Impact factor: 5.344
Authors: Joshua Montroy; Rodney H Breau; Sonya Cnossen; Kelsey Witiuk; Andrew Binette; Taylor Ferrier; Luke T Lavallée; Dean A Fergusson; David Schramm Journal: PLoS One Date: 2016-01-26 Impact factor: 3.240