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dc.contributor.authorCorcoran Tomas Ben_US
dc.contributor.authorMyles Paul Sen_US
dc.contributor.authorForbes Andrew Ben_US
dc.contributor.authorCheng Allen Cen_US
dc.contributor.authorBach Leon Aen_US
dc.contributor.authorO'Loughlin Edmonden_US
dc.contributor.authorLeslie Kateen_US
dc.contributor.authorChan Matthew TVen_US
dc.contributor.authorStory Daviden_US
dc.contributor.authorShort Timothy Gen_US
dc.contributor.authorMartin Catherineen_US
dc.contributor.authorCoutts Paulineen_US
dc.contributor.authorHo Kowk Men_US
dc.contributor.authorPADDI Investigatorsen_US
dc.contributor.authorAustralian and New Zealand College of Anaesthetists Clinical Trials Networken_US
dc.contributor.authorAustralasian Society for Infectious Diseases Clinical Research Networken_US
dc.description.abstractBackground: 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.subjectPostoperative Nausea and Vomitingen_US
dc.subjectSurgical Wound Infectionen_US
dc.titleDexamethasone and Surgical-Site Infectionen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleN Engl J Meden_US
dc.type.studyortrialCase Control Studiesen_US
dc.contributor.anzcaaddPADDI Investigatorsen_US
dc.contributor.anzcaaddAustralasian Society for Infectious Diseases Clinical Research Networken_US
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
Appears in Collections:Scholarly and Clinical
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