The safety and efficacy of dexamethasone in the perioperative management of glioma patients

In this single-institution retrospective cohort study, the authors evaluated the effect of dexamethasone on postoperative complications and overall survival in patients with glioma undergoing resection. A total of 435 patients who underwent resection of a primary glioma were included in this retrosp...

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Published inJournal of neurosurgery Vol. 136; no. 4; p. 1062
Main Authors Medikonda, Ravi, Patel, Kisha, Jackson, Christina, Saleh, Laura, Srivastava, Siddhartha, Feghali, James, Mohan, Aditya, Pant, Ayush, Jackson, Christopher M, Weingart, Jon, Mukherjee, Debraj, Bettegowda, Chetan, Gallia, Gary L, Brem, Henry, Lim, Michael
Format Journal Article
LanguageEnglish
Published United States 01.04.2022
Subjects
Dexamethasone - adverse effects
Glioma - surgery
Humans
Hyperglycemia
Postoperative Period
Retrospective Studies
dexamethasone
postoperative
preoperative
perioperative
primary glioma
steroids
oncology
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Summary:In this single-institution retrospective cohort study, the authors evaluated the effect of dexamethasone on postoperative complications and overall survival in patients with glioma undergoing resection. A total of 435 patients who underwent resection of a primary glioma were included in this retrospective cohort study. The inclusion criterion was all patients who underwent resection of a primary glioma at a tertiary medical center between 2014 and 2019. The use of both pre- and postoperative dexamethasone demonstrated a trend toward the development of postoperative wound infections (3% vs 0% in single use or no use, p = 0.082). No association was detected between dexamethasone use and the development of new-onset hyperglycemia (p = 0.149). On multivariable Cox proportional hazards analysis, dexamethasone use was associated with a greater hazard of death (overall p = 0.017); this effect was most pronounced for preoperative (only) dexamethasone use (hazard ratio 3.0, p = 0.062). Combined pre- and postoperative dexamethasone use may increase the risk of postoperative wound infection, and dexamethasone use, specifically preoperative use, may negatively impact survival. These findings highlight the potential for serious negative consequences with dexamethasone use.
ISSN:1933-0693
DOI:10.3171/2021.4.JNS204127