Impact of High Preoperative Steroid Doses on Postoperative Complications among Patients on Prolonged Preoperative Steroid Therapy

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  • Iguchi Tomohiro
    Department of Surgery, Fukuoka Higashi Medical Center | Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Shirabe Ken
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Inoue Kentaro
    Department of Surgery, Fukuoka Higashi Medical Center
  • Ito Shuhei
    Department of Surgery, Fukuoka Higashi Medical Center
  • Ohga Takefumi
    Department of Surgery, Fukuoka Higashi Medical Center
  • Nozoe Tadahiro
    Department of Surgery, Fukuoka Higashi Medical Center
  • Ezaki Takahiro
    Department of Surgery, Fukuoka Higashi Medical Center
  • Yoshizumi Tomoharu
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Uchiyama Hideaki
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Soejima Yuji
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Ikegami Toru
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Yamashita Yo-ichi
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Kawanaka Hirofumi
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Ikeda Tetsuo
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Saeki Hiroshi
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Morita Masaru
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
  • Maehara Yoshihiko
    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University

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Other Title
  • 長期ステロイド内服患者の術後合併症におけるステロイド内服量の影響

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Abstract

Corticosteroids are essential to maintain the organic homeostasis. Steroid, glucocorticoid or its synthetic analog is widely used for inflammatory and autoimmune diseases. Prolonged steroid therapy is reported to cause the susceptibility to infection, impaired wound healing and psychoneurosis, however whether the quantity of taking the preoperative steroid is associated the postoperative complication is still unknown. The aim of this study was to elucidate whether the steroid dose in patients on prolonged preoperative steroid therapy is associated postoperative morbidity and mortality. Twenty-five patients taking steroid for various illnesses and underwent the surgery under general anesthesia were selected in this study. The mean ± standard deviation and the median of the steroid dose converted into hydrocortisone (mg/day) were 39.2 ± 31.0 and 20, respectively. Of 25 cases, postoperative complications were seen in 10 cases. The postoperative complication was severe based on the grade of Clavien and Dindo by ANOVA as the doses of taking steroid increased (p = 0.0171). The grave postoperative complication classified as Clavien and Dindo grade III occurred with 100% sensitivity and 87% specificity for the steroid dose converted into hydrocortisone > 80mg/day. Preoperative taking the large amount of steroid (> 80mg/day) could cause a grave complication. More careful selection of the operative procedure might improve the mobidity rate.

Journal

  • 福岡醫學雜誌

    福岡醫學雜誌 104 (12), 499-506, 2013-12-25

    Fukuoka Medical Association

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