Safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort study
Abstract Purpose Perioperative intravenous different doses of dexamethasone (DEX) can realize effective clinical outcomes in total joint arthroplasty (TJA). However, the effect of different DEX doses on readmission rates and postoperative complications remains unclear. Methods We retrospectively ana...
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BMC
2024-12-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08225-z |
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| author | Ping Mou Xiao-Dan Zhao Xiu-Mei Tang Zun-Han Liu Hao-Yang Wang Wei-Nan Zeng Duan Wang Zong-Ke Zhou |
| author_facet | Ping Mou Xiao-Dan Zhao Xiu-Mei Tang Zun-Han Liu Hao-Yang Wang Wei-Nan Zeng Duan Wang Zong-Ke Zhou |
| author_sort | Ping Mou |
| collection | DOAJ |
| description | Abstract Purpose Perioperative intravenous different doses of dexamethasone (DEX) can realize effective clinical outcomes in total joint arthroplasty (TJA). However, the effect of different DEX doses on readmission rates and postoperative complications remains unclear. Methods We retrospectively analyzed patients who underwent primary TJA between December 2012 and October 2020. Patients were categorized into three groups based on the total perioperative dose of DEX: control group (DEX = 0 mg), low-dose group (DEX < 15 mg), and high-dose group (DEX ≥ 15 mg). Primary outcomes included 30-day and 90-day readmission rates. Secondary outcomes included the rates of periprosthetic joint infection (PJI) and wound complications, with treatment outcomes for these complications were also evaluated. Multivariable analysis was used to identify risk factors for readmission. Results A total of 14,557 procedures were included, with 6,686 in the control group, 4,325 in the low-dose group, and 3,546 in the high-dose group. No significant differences were observed among the groups for 30-day (p = 0.645) or 90-day readmission rates (p = 0.539). Additionally, there were no significant differences in rates of PJI (p = 0.401) or wound complications (p = 0.079). Treatment for PJI and wound complications was successful across all groups. Risk factors for 30-day readmission included age > 80 years (OR: 2.585, 95% CI: 1.123–5.954, p = 0.026) and undergoing total hip arthroplasty (THA) (OR: 1.692, 95% CI: 1.137–2.518, p = 0.009). For 90-day readmission, age 71–80 years (OR: 2.199, 95% CI: 1.349–3.583, p = 0.002), age > 80 years (OR: 3.897, 95% CI: 1.966–7.727, p < 0.001), and THA (OR: 1.622, 95% CI: 1.179–2.230, p = 0.003) were significant risk factors. However, neither low-dose nor high-dose DEX was associated with increased 30-day or 90-day readmission rates. Conclusions Perioperative intravenous DEX may be not associated with the readmission, PJI, and wound complications in patients undergoing primary TJA. |
| format | Article |
| id | doaj-art-e2f70dc239934e74861e63a94032b8cb |
| institution | DOAJ |
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| language | English |
| publishDate | 2024-12-01 |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-e2f70dc239934e74861e63a94032b8cb2025-08-20T02:39:48ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-0125111110.1186/s12891-024-08225-zSafety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort studyPing Mou0Xiao-Dan Zhao1Xiu-Mei Tang2Zun-Han Liu3Hao-Yang Wang4Wei-Nan Zeng5Duan Wang6Zong-Ke Zhou7Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan UniversityTrauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, School of Medicine, West China Hospital, Sichuan UniversityDepartment of Sports Medicine Center, State Key Laboratory of Trauma, Burn and Combined Injury, the First Affiliated Hospital of the Army Military Medical UniversityDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan UniversityAbstract Purpose Perioperative intravenous different doses of dexamethasone (DEX) can realize effective clinical outcomes in total joint arthroplasty (TJA). However, the effect of different DEX doses on readmission rates and postoperative complications remains unclear. Methods We retrospectively analyzed patients who underwent primary TJA between December 2012 and October 2020. Patients were categorized into three groups based on the total perioperative dose of DEX: control group (DEX = 0 mg), low-dose group (DEX < 15 mg), and high-dose group (DEX ≥ 15 mg). Primary outcomes included 30-day and 90-day readmission rates. Secondary outcomes included the rates of periprosthetic joint infection (PJI) and wound complications, with treatment outcomes for these complications were also evaluated. Multivariable analysis was used to identify risk factors for readmission. Results A total of 14,557 procedures were included, with 6,686 in the control group, 4,325 in the low-dose group, and 3,546 in the high-dose group. No significant differences were observed among the groups for 30-day (p = 0.645) or 90-day readmission rates (p = 0.539). Additionally, there were no significant differences in rates of PJI (p = 0.401) or wound complications (p = 0.079). Treatment for PJI and wound complications was successful across all groups. Risk factors for 30-day readmission included age > 80 years (OR: 2.585, 95% CI: 1.123–5.954, p = 0.026) and undergoing total hip arthroplasty (THA) (OR: 1.692, 95% CI: 1.137–2.518, p = 0.009). For 90-day readmission, age 71–80 years (OR: 2.199, 95% CI: 1.349–3.583, p = 0.002), age > 80 years (OR: 3.897, 95% CI: 1.966–7.727, p < 0.001), and THA (OR: 1.622, 95% CI: 1.179–2.230, p = 0.003) were significant risk factors. However, neither low-dose nor high-dose DEX was associated with increased 30-day or 90-day readmission rates. Conclusions Perioperative intravenous DEX may be not associated with the readmission, PJI, and wound complications in patients undergoing primary TJA.https://doi.org/10.1186/s12891-024-08225-zTotal joint arthroplastyDexamethasoneReadmissionPeriprosthetic joint infectionWound complications |
| spellingShingle | Ping Mou Xiao-Dan Zhao Xiu-Mei Tang Zun-Han Liu Hao-Yang Wang Wei-Nan Zeng Duan Wang Zong-Ke Zhou Safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort study BMC Musculoskeletal Disorders Total joint arthroplasty Dexamethasone Readmission Periprosthetic joint infection Wound complications |
| title | Safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort study |
| title_full | Safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort study |
| title_fullStr | Safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort study |
| title_full_unstemmed | Safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort study |
| title_short | Safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty: a retrospective large-scale cohort study |
| title_sort | safety of perioperative intravenous different doses of dexamethasone in primary total joint arthroplasty a retrospective large scale cohort study |
| topic | Total joint arthroplasty Dexamethasone Readmission Periprosthetic joint infection Wound complications |
| url | https://doi.org/10.1186/s12891-024-08225-z |
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