Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study
ABSTRACT Background and Aims Abdominal sepsis refers to a severe and potentially life‐threatening condition characterized by the presence of infection, inflammation, and tissue damage within the abdominal cavity. Glucocorticoids (GCs) play an important role in regulation of the host immune and infla...
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Wiley
2025-02-01
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| Online Access: | https://doi.org/10.1002/hsr2.70360 |
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| author | Tianzhu Tao Yue Shi Xiaofei Ye Weidong Mi Jingsheng Lou |
| author_facet | Tianzhu Tao Yue Shi Xiaofei Ye Weidong Mi Jingsheng Lou |
| author_sort | Tianzhu Tao |
| collection | DOAJ |
| description | ABSTRACT Background and Aims Abdominal sepsis refers to a severe and potentially life‐threatening condition characterized by the presence of infection, inflammation, and tissue damage within the abdominal cavity. Glucocorticoids (GCs) play an important role in regulation of the host immune and inflammation responses involved in sepsis and surgery. This study aimed to investigate the potential impact of intraoperative GCs administration on the clinical outcome of surgical patients with abdominal sepsis. Methods This retrospective cohort study included a 1:1 propensity score–matched cohort of surgical patients afflicted with abdominal sepsis at two medical centers from January 2008 to December 2022. Patients were classified into low‐GCs, high‐GCs, and non‐GCs groups according to the dosage of steroids used intraoperatively, and in‐hospital mortality was designated as the primary outcome. Results This study included a total of 476 patients, with 217 in the non‐GCs group, 213 in the low‐GCs group, and 46 in the high‐GCs group. The overall in‐hospital mortality rate was 7.56%. After propensity score matching (PSM), there were 168 cases in both the low‐GCs group and the non‐GCs group, with no significant differences observed between the groups regarding mortality rate, length of hospital‐stay, and duration of intensive care unit (ICU) stay. In patients with septic shock, the use of low‐dose GCs increased the urine output and decreased the requirements for vasopressors on the first postoperative day, however, it had no impact on the in‐hospital mortality or ICU stay. Moreover, prophylactic use of GCs during anesthesia induction did not decrease the incidence of intraoperative hypotension or necessity of vasopressors use. Conclusion Intraoperative administration of low‐dose GCs demonstrates a transient improvement in hemodynamics of patients with septic shock, however, it did not lead to improved clinical outcomes. Further research remains necessary to elucidate the optimal perioperative dosing strategy. |
| format | Article |
| id | doaj-art-b22b12f5767d4dbdb304df2b4ea4692b |
| institution | OA Journals |
| issn | 2398-8835 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
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| series | Health Science Reports |
| spelling | doaj-art-b22b12f5767d4dbdb304df2b4ea4692b2025-08-20T02:11:08ZengWileyHealth Science Reports2398-88352025-02-0182n/an/a10.1002/hsr2.70360Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort StudyTianzhu Tao0Yue Shi1Xiaofei Ye2Weidong Mi3Jingsheng Lou4Department of Anesthesiology Air Force Medical Center Beijing ChinaDepartment of Anesthesiology Air Force Medical Center Beijing ChinaDepartment of Military Health Statistics Faculty of Health Services Naval Medical University (Second Military Medical University) Shanghai ChinaAnesthesia and Operation Center, First Medical Center of the General Hospital of the People's Liberation Army Beijing ChinaAnesthesia and Operation Center, First Medical Center of the General Hospital of the People's Liberation Army Beijing ChinaABSTRACT Background and Aims Abdominal sepsis refers to a severe and potentially life‐threatening condition characterized by the presence of infection, inflammation, and tissue damage within the abdominal cavity. Glucocorticoids (GCs) play an important role in regulation of the host immune and inflammation responses involved in sepsis and surgery. This study aimed to investigate the potential impact of intraoperative GCs administration on the clinical outcome of surgical patients with abdominal sepsis. Methods This retrospective cohort study included a 1:1 propensity score–matched cohort of surgical patients afflicted with abdominal sepsis at two medical centers from January 2008 to December 2022. Patients were classified into low‐GCs, high‐GCs, and non‐GCs groups according to the dosage of steroids used intraoperatively, and in‐hospital mortality was designated as the primary outcome. Results This study included a total of 476 patients, with 217 in the non‐GCs group, 213 in the low‐GCs group, and 46 in the high‐GCs group. The overall in‐hospital mortality rate was 7.56%. After propensity score matching (PSM), there were 168 cases in both the low‐GCs group and the non‐GCs group, with no significant differences observed between the groups regarding mortality rate, length of hospital‐stay, and duration of intensive care unit (ICU) stay. In patients with septic shock, the use of low‐dose GCs increased the urine output and decreased the requirements for vasopressors on the first postoperative day, however, it had no impact on the in‐hospital mortality or ICU stay. Moreover, prophylactic use of GCs during anesthesia induction did not decrease the incidence of intraoperative hypotension or necessity of vasopressors use. Conclusion Intraoperative administration of low‐dose GCs demonstrates a transient improvement in hemodynamics of patients with septic shock, however, it did not lead to improved clinical outcomes. Further research remains necessary to elucidate the optimal perioperative dosing strategy.https://doi.org/10.1002/hsr2.70360abdominal sepsisgeneral anesthesiamortalityretrospectiverisk factorssurgical patients |
| spellingShingle | Tianzhu Tao Yue Shi Xiaofei Ye Weidong Mi Jingsheng Lou Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study Health Science Reports abdominal sepsis general anesthesia mortality retrospective risk factors surgical patients |
| title | Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study |
| title_full | Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study |
| title_fullStr | Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study |
| title_full_unstemmed | Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study |
| title_short | Intraoperative Low‐Dose Glucocorticoids in Surgical Patients With Abdominal Sepsis: A Multicenter Retrospective Cohort Study |
| title_sort | intraoperative low dose glucocorticoids in surgical patients with abdominal sepsis a multicenter retrospective cohort study |
| topic | abdominal sepsis general anesthesia mortality retrospective risk factors surgical patients |
| url | https://doi.org/10.1002/hsr2.70360 |
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