Surgery in patients on long-term steroid therapy: A tentative model for risk assessment
✍ Scribed by R. Reding; Dr L. A. Michel; J. Donckier; L. De Canniere; J. Jamart
- Publisher
- John Wiley and Sons
- Year
- 1990
- Tongue
- English
- Weight
- 455 KB
- Volume
- 77
- Category
- Article
- ISSN
- 0007-1323
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✦ Synopsis
Surgery in patients on long-term steroid therapy: a tentative model for risk assessment
Increased morbidity after operation has been associated with long-term steroid therapy. To determine the correlation between steroid therapy and such morbidity, the perioperative course of 55 steroid-treated patients was reviewed: 27 had bronchopulmonary disorders (group P ) and 28 had non-pulmonary diseases (group NP). There were six (1 I per cent) deaths, of which three were steroid related. Among the 13 non-lethal postoperative complications, eight were considered to be steroid related in group P and one in group N P . The duration of steroid therapy was for a median of 24 months (range 1-408 months) in group P and for a median of 6 months (range 1-240 months) in group NP ( P < 0.01). In contrast, the daily dose of hydrocortisone or equivalent before operation was significantly lower in group P, with a median of 0.51 mg kg-" day-' (range 0.20-2.56 mg kg-' day-') than in group NP, with a median of 1.20 mg kg-' day-' (range 0-23-7-38 mg kgday-') (P -= 0.01). In conclusion, bronchopulrnonary disorders requiring a long duration of steroid therapy are associated with a higher risk of steroid-related complications after surgery. A convenient mathematical model is proposed which may allow a preoperative assessment of surgical risk, using steroid dose and duration of treatment.