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Does Chronic Use of Steroids Affect Outcomes After Liver Resection? Analysis of a National Database

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

With the increasing age of patients, more patients on chronic preoperative steroids are undergoing liver resections. Our study aimed to assess the relationship between preoperative steroids and outcomes.

Methods

We performed a retrospective review of the 2014–2019 NSQIP database of all patients undergoing liver resections. Propensity score matching was utilized to match the two groups (chronic steroids vs. no steroids) based on demographics, preoperative laboratory data, and operative findings. The primary outcome measure was mortality.

Results

There were 712 patients in the chronic steroid group and 21,751 in the no steroid group. After propensity score matching; there were 420 patients in both groups. Post-match analysis again demonstrated that patients on chronic steroids were at higher risk of cardiac arrest than those not on steroids (OR 2.01, 95% CI 1.02–2.45, p = 0.04). In addition, rates of organ space wound infection (OR 2.66, CI 1.33–5.38, p = 0.03), superficial wound infection (OR 2.79, CI 1.08–5.41, p = 0.035), renal insufficiency (OR 1.25, CI 1.03–1.62, p = 0.02), postoperative sepsis (OR 1.28, CI 1.08–1.82, p = 0.04), DVT (OR 1.7, CI 1.01–2.82, p = 0.04), and bile leakage (OR 1.75, CI 1.24–3.36, p = 0.04) were also increased in patients on steroids. However, the matched cohorts were similar in postoperative mortality rates (OR 0.11, CI 0.6–1.17, p = 0.72).

Conclusion

The study found higher morbidity rates in patients undergoing liver resections on chronic preoperative steroids but no differences in mortality.

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Authors and Affiliations

  1. Division of Transplant and Hepatobiliary Surgery, Tufts Medical Center, Tufts University School of Medicine, 800 Washington St., Boston, MA, USA

    Hassan Aziz, Ye In Christopher Kwon, Saba Alvi, Shahzaib Ahmad & Martin Goodman

  2. The George Washington University School of Medicine and Health Sciences, Washington, DC, USA

    Sangrag Ganguli

  3. Division of Transplant and Hepatobiliary Surgery, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA

    Yong K. Kwon

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  1. Hassan Aziz
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  2. Ye In Christopher Kwon
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Correspondence to Hassan Aziz.

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Accepted Oral Presentation at the American College of Surgeons, Oct 2022, San Diego, CA

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Aziz, H., Kwon, Y.I.C., Alvi, S. et al. Does Chronic Use of Steroids Affect Outcomes After Liver Resection? Analysis of a National Database. J Gastrointest Surg 26, 2093–2100 (2022). https://doi.org/10.1007/s11605-022-05393-y

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  • DOI: https://doi.org/10.1007/s11605-022-05393-y

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