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News

Use of glucocorticoids and mortality after colorectal cancer surgery

A study in the latest issue of the Alimentary Pharmacology & Therapeutics investigates pre-admission use of glucocorticoids and 30-day mortality following colorectal cancer surgery.

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Previous studies indicate that pre-admission glucocorticoids increase the risk of perioperative complications.

Dr Ostenfeld and colleagues from Denmark examined whether pre-admission use of glucocorticoids affects 30-day mortality after colorectal cancer (CRC) surgery.

The research team conducted a nationwide population-based cohort study by linking Danish medical registries.

All residents in Denmark who underwent CRC surgery from 2001 to 2011 were included.

The team characterized subjects who filled their most recent glucocorticoid prescription ≤90, 91–365 and >365 days before their surgery date as prevalent, recent and former users, respectively.

Prevalent users were subgrouped into new and continuing users.

Among new users, the 30-day mortality was 18%
Alimentary Pharmacology & Therapeutics

The team estimated 30-day cumulative mortality by the Kaplan–Meier method and corresponding mortality rate ratios (MRRs) using Cox proportional hazard regression, adjusting for potential confounders.

Of the 34,641 colorectal cancer patients included, 3966 had filled one or more prescriptions of glucocorticoids within the year before the surgery date.

Thirty-day mortality among prevalent users of oral glucocorticoids was 15.0% vs. 7.3% among non-users.

Among new users, the 30-day mortality was 18% while it was 14% among continuing users.

The research team found no associations for recent or former use of oral glucocorticoids nor for use of inhaled, intestinal-acting, and mixed glucocorticoids.

Dr Ostenfeld's team comments, "Prevalent use, particulary new use, of oral glucocorticoids was associated with markedly increased 30-day mortality after colorectal cancer surgery compared to patients not exposed to any glucocorticoids."

Aliment Pharmacol Ther 2014: 39(8): 843–853
28 March 2014

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