{"id":20331,"date":"2021-07-25T05:01:00","date_gmt":"2021-07-24T21:01:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=20331"},"modified":"2021-07-26T22:39:43","modified_gmt":"2021-07-26T14:39:43","slug":"bmj%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%bd%8e%e5%a1%9e%e7%b1%b3%e6%9d%be%e5%af%b9%e9%9d%9e%e5%bf%83%e8%84%8f%e5%a4%a7%e6%89%8b%e6%9c%af%e5%90%8e%e5%b9%b6%e5%8f%91%e7%97%87%e6%88%96","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=20331","title":{"rendered":"[BMJ\u53d1\u8868\u8bba\u6587]\uff1a\u5730\u585e\u7c73\u677e\u5bf9\u975e\u5fc3\u810f\u5927\u624b\u672f\u540e\u5e76\u53d1\u75c7\u6216\u5168\u56e0\u75c5\u6b7b\u7387\u7684\u5f71\u54cd"},"content":{"rendered":"\n

Research<\/strong><\/p>\n\n\n\n

Effect of dexamethasone on complications or all cause mortality after major non-cardiac surgery: multicentre, double blind, randomised controlled trial<\/h1>\n\n\n\n

Karim Asehnoune, Charlene Le Moal, Gilles Lebuffe, et al<\/h3>\n\n\n\n

BMJ<\/em> 2021; 373 doi: https:\/\/doi.org\/10.1136\/bmj.n1162<\/a> (Published 02 June 2021)Cite this as: BMJ<\/em> 2021;373:n1162<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Objective<\/strong><\/h3>\n\n\n\n

To assess the effect of dexamethasone on complications or all cause mortality after major non-cardiac surgery.<\/p>\n\n\n\n

Design<\/strong><\/h3>\n\n\n\n

Phase III, randomised, double blind, placebo controlled trial.<\/p>\n\n\n\n

Setting<\/strong><\/h3>\n\n\n\n

34 centres in France, December 2017 to March 2019.<\/p>\n\n\n\n

Participants<\/strong><\/h3>\n\n\n\n

1222 adults (>50 years) requiring major non-cardiac surgery with an expected duration of more than 90 minutes. The anticipated time frame for recruitment was 24 months.<\/p>\n\n\n\n

Interventions<\/strong><\/h3>\n\n\n\n

Participants were randomised to receive either dexamethasone (0.2 mg\/kg immediately after the surgical procedure, and on day 1) or placebo. Randomisation was stratified on the two prespecified criteria of cancer and thoracic procedure.<\/p>\n\n\n\n

Main outcomes measures<\/strong><\/h3>\n\n\n\n

The primary outcome was a composite of postoperative complications or all cause mortality within 14 days after surgery, assessed in the modified intention-to-treat population (at least one treatment administered).<\/p>\n\n\n\n

Results<\/strong><\/h3>\n\n\n\n

Of the 1222 participants who underwent randomisation, 1184 (96.9%) were included in the modified intention-to-treat population. 14 days after surgery, 101 of 595 participants (17.0%) in the dexamethasone group and 117 of 589 (19.9%) in the placebo group had complications or died (adjusted odds ratio 0.81, 95% confidence interval 0.60 to 1.08; P=0.15). In the stratum of participants who underwent non-thoracic surgery (n=1038), the primary outcome occurred in 69 of 520 participants (13.3%) in the dexamethasone group and 93 of 518 (18%) in the placebo group (adjusted odds ratio 0.70, 0.50 to 0.99). Adverse events were reported in 288 of 613 participants (47.0%) in the dexamethasone group and 296 of 609 (48.6%) in the placebo group (P=0.46).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions<\/strong><\/h3>\n\n\n\n

Dexamethasone was not found to significantly reduce the incidence of complications and death in patients 14 days after major non-cardiac surgery. The 95% confidence interval for the main result was, however, wide and suggests the possibility of important clinical effectiveness.<\/p>\n\n\n\n

Trial registratio<\/strong>n<\/h3>\n\n\n\n

ClinicalTrials.gov NCT03218553<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research Effect of dexamethasone on complications or al […]<\/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\/20331"}],"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=20331"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20331\/revisions"}],"predecessor-version":[{"id":20424,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20331\/revisions\/20424"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20331"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20331"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20331"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}