Please use this identifier to cite or link to this item:
https://hdl.handle.net/11055/1101
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DC Field | Value | Language |
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dc.contributor.author | Corcoran Tomas B | en_US |
dc.contributor.author | Myles Paul S | en_US |
dc.contributor.author | Forbes Andrew B | en_US |
dc.contributor.author | Cheng Allen C | en_US |
dc.contributor.author | Bach Leon A | en_US |
dc.contributor.author | O'Loughlin Edmond | en_US |
dc.contributor.author | Leslie Kate | en_US |
dc.contributor.author | Chan Matthew TV | en_US |
dc.contributor.author | Story David | en_US |
dc.contributor.author | Short Timothy G | en_US |
dc.contributor.author | Martin Catherine | en_US |
dc.contributor.author | Coutts Pauline | en_US |
dc.contributor.author | Ho Kowk M | en_US |
dc.contributor.author | PADDI Investigators | en_US |
dc.contributor.author | Australian and New Zealand College of Anaesthetists Clinical Trials Network | en_US |
dc.contributor.author | Australasian Society for Infectious Diseases Clinical Research Network | en_US |
dc.date.accessioned | 2021-05-07T00:44:07Z | - |
dc.date.available | 2021-05-07T00:44:07Z | - |
dc.date.issued | 2021-05-06 | - |
dc.identifier.citation | 384(18):1731-1741 | en_US |
dc.identifier.issn | 0028-4793 | en_US |
dc.identifier.uri | http://hdl.handle.net/11055/1101 | - |
dc.description.abstract | Background: The glucocorticoid dexamethasone prevents nausea and vomiting after surgery, but there is concern that it may increase the risk of surgical-site infection. less... Methods: In this pragmatic, international, noninferiority trial, we randomly assigned 8880 adult patients who were undergoing nonurgent, noncardiac surgery of at least 2 hours' 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. Results: 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, -0.9 percentage points; 95.6% confidence interval [CI], -2.1 to 0.3; P<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. Conclusions: 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, ACTRN12614001226695.). | en_US |
dc.subject | Postoperative Nausea and Vomiting | en_US |
dc.subject | Dexamethasone | en_US |
dc.subject | Surgical Wound Infection | en_US |
dc.subject | glucocorticoid | en_US |
dc.subject | Diabetes | en_US |
dc.title | Dexamethasone and Surgical-Site Infection | en_US |
dc.type | Journal Article | en_US |
dc.type.content | Text | en_US |
dc.identifier.journaltitle | N Engl J Med | en_US |
dc.identifier.doi | 10.1056/NEJMoa2028982 | en_US |
dc.description.pubmeduri | https://pubmed.ncbi.nlm.nih.gov/33951362/ | en_US |
dc.type.studyortrial | Case Control Studies | en_US |
dc.contributor.anzcaadd | PADDI Investigators | en_US |
dc.contributor.anzcaadd | Australasian Society for Infectious Diseases Clinical Research Network | en_US |
item.grantfulltext | none | - |
item.fulltext | No Fulltext | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.cerifentitytype | Publications | - |
item.openairetype | Journal Article | - |
Appears in Collections: | Scholarly and Clinical |
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