{"id":20209,"date":"2021-05-29T05:20:00","date_gmt":"2021-05-28T21:20:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=20209"},"modified":"2021-05-30T06:07:39","modified_gmt":"2021-05-29T22:07:39","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%9c%b0%e5%a1%9e%e7%b1%b3%e6%9d%be%e4%b8%8e%e6%89%8b%e6%9c%af%e9%83%a8%e4%bd%8d%e6%84%9f%e6%9f%93","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=20209","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u5730\u585e\u7c73\u677e\u4e0e\u624b\u672f\u90e8\u4f4d\u611f\u67d3"},"content":{"rendered":"\n<p><a class=\"\" href=\"https:\/\/www.nejm.org\/medical-articles\/original-article\">ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Dexamethasone and Surgical-Site Infection<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Tom\u00e1s B. Corcoran, Paul S. Myles, Andrew B. Forbes,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">N Engl J Med 2021; 384:1731-1741<br \/>DOI: 10.1056\/NEJMoa2028982<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">BACKGROUND<\/h3>\n\n\n\n<p>The glucocorticoid dexamethasone prevents nausea and vomiting after surgery, but there is concern that it may increase the risk of surgical-site infection.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">METHODS<\/h3>\n\n\n\n<p>In this pragmatic, international, noninferiority trial, we randomly assigned 8880 adult patients who were undergoing nonurgent, noncardiac surgery of at least 2 hours\u2019 duration, with a skin incision length longer than 5 cm and a postoperative overnight hospital stay, to receive 8 mg of intravenous dexamethasone or matching placebo while under anesthesia. Randomization was stratified according to diabetes status and trial center. The primary outcome was surgical-site infection within 30 days after surgery. The prespecified noninferiority margin was 2.0 percentage points.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">RESULTS<\/h3>\n\n\n\n<p>A total of 8725 participants were included in the modified intention-to-treat population (4372 in the dexamethasone group and 4353 in the placebo group), of whom 13.2% (576 in the dexamethasone group and 572 in the placebo group) had diabetes mellitus. Of the 8678 patients included in the primary analysis, surgical-site infection occurred in 8.1% (354 of 4350 patients) assigned to dexamethasone and in 9.1% (394 of 4328) assigned to placebo (risk difference adjusted for diabetes status, \u22120.9 percentage points; 95.6% confidence interval [CI], \u22122.1 to 0.3; P&lt;0.001 for noninferiority). The results for superficial, deep, and organ-space surgical-site infections and in patients with diabetes were similar to those of the primary analysis. Postoperative nausea and vomiting in the first 24 hours after surgery occurred in 42.2% of patients in the dexamethasone group and in 53.9% in the placebo group (risk ratio, 0.78; 95% CI, 0.75 to 0.82). Hyperglycemic events in patients without diabetes occurred in 22 of 3787 (0.6%) in the dexamethasone group and in 6 of 3776 (0.2%) in the placebo group.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">CONCLUSIONS<\/h3>\n\n\n\n<p>Dexamethasone was noninferior to placebo with respect to the incidence of surgical-site infection within 30 days after nonurgent, noncardiac surgery. (Funded by the Australian National Health and Medical Research Council and others; PADDI Australian New Zealand Clinical Trials Registry number,&nbsp;<a href=\"https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?ACTRN=12614001226695\" target=\"_blank\" rel=\"noreferrer noopener\">ACTRN12614001226695. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ORIGINAL ARTICLE Dexamethasone and Surgical-Site Infect [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20209"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20209"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20209\/revisions"}],"predecessor-version":[{"id":20210,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20209\/revisions\/20210"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20209"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20209"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20209"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}