Risk of peri-operative complications in children receiving preoperative steroids

Mets, Elbert J.; Chouairi, Fouad; Mirza, Humza N.; Allam, Omar; Park, Kitae Eric; Junn, Alexandra; Alperovich, Michael

doi:10.1007/s00383-020-04742-9

Cited by 3 publications

(2 citation statements)

References 40 publications

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“…Previous studies (n < 100) also indicate that PPIs and steroids ± have no effect on the likelihood of persistent GCF occurrence [13,15,29]. Regarding perioperative complications, a larger paediatric study (n = 425,251) concluded that chronic steroid use was associated with increased perioperative complications across all types of surgery [30]. Our study is smaller, and limited to one type of surgical procedure only.…”

Section: Discussionmentioning

confidence: 52%

Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications & Growth Outcome

Nguyen,

Kennedy,

Varajavandi

et al. 2023

Preprint

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Purpose To determine the incidence of and risk factors for complications after gastrostomy tube removal in children and to investigate whether complications are associated with growth outcome. Methodology: Medical records of 108 patients, who underwent gastrostomy removal and gastrostomy site closure, between January 2014 to July 2022 at a single institution, were reviewed. Clinical factors were analysed for association with complications and growth outcomes. Results Complications occurred in 39% (42/108) of patients. Persistent gastrocutaneous fistula (GCF) (20/108, 18%) and perioperative complications (16/82, 20%) were most frequent. Attempted non-operative closure (NOC), PPI use, and steroid use were more frequent in patients with complications (64.3% vs 28.8%, p = 0.001; 57.3% vs 32.3%, p = 0.029; 29.3% vs 12.5%, p = 0.033 respectively). Patients with persistent GCF had longer mean duration of gastrostomy placement (40.45 ± 35.36 vs 15.96 ± 16.94 months, p=0.008) and greater occurrence of pre-existing non-reflux gastrointestinal disease (40% vs 12%, p=0.038). Mean growth z-scores were maintained at 6 months, 18 months and 5 years follow-up in patients with and without complications. Conclusion Attempted NOC, PPIs, and steroids were risk factors for complications after gastrostomy removal. Longer duration of gastrostomy placement and non-reflux gastrointestinal disease were risk factors for persistent GCF. Complications were not associated with poorer growth outcome.

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Section: Discussionmentioning

confidence: 52%

Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications & Growth Outcome

Nguyen,

Kennedy,

Varajavandi

et al. 2023

Preprint

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show abstract

“…Other risk factors such as steroid and NSAID exposure were identified, which come along with severe prematurity and its comorbidities. Long-term corticosteroid use has already been identified as a risk factor in adults 8,26,27 and has also been independently associated with SWD in the pediatric population, 28 explained by the resulting impaired wound healing. 29 On the other hand, several studies have shown that NSAID use has a controversial impact on wound healing.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy

Miholjcic,

Baud,

Iranmanesh

et al. 2023

Eur J Pediatr Surg

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Background Surgical wound dehiscence (SWD) in neonates is a life-threatening complication. The aim was to define risk factors of postoperative incision dehiscence in this population. Methods Data of 144 patients from 2010 to 2020 were analyzed retrospectively. All full-term newborns or preterm newborns up to 42 weeks of amenorrhea (adjusted) who had a laparotomy within 30 days were included. Descriptive patient information and perioperative data were collected. SWD was defined as any separation of cutaneous edges of postoperative wounds. Results Overall, SWD occurred in 16/144 (11%) patients, with a significantly increased incidence in preterm newborns (13/59, 22%) compared with full-term newborns (3/85, 4%; p < 0.001). SWD was significantly associated with exposure to postnatal steroids (60% vs. 4%, p < 0.001) and nonsteroidal anti-inflammatory drugs (25% vs. 4%, p < 0.01), invasive ventilation duration before surgery (median at 10 vs. 0 days, p < 0.001), preoperative low hemoglobin concentration (115 vs. 147 g/L, p < 0.001) and platelet counts (127 vs. 295 G/L, p < 0.001), nonabsorbable suture material (43% vs. 8%, p < 0.001), the presence of ostomies (69% vs. 18%, p < 0.001), positive bacteriological wound cultures (50% vs. 6%, p < 0.001), and relaparotomy (25% vs. 3%, p < 0.01). Thirteen of 16 patients with SWD presented necrotizing enterocolitis/intestinal perforations (81%, p < 0.001). Conclusion This study identified prematurity and a number of other factors linked to the child's general condition as risk factors for SWD. Some of these can help physicians recognize and respond to at-risk patients and provide better counseling for parents.

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Adverse Effect of Preoperative Steroid Use on Surgical Outcomes

Garapati¹

2020

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Risk of peri-operative complications in children receiving preoperative steroids

Cited by 3 publications

References 40 publications

Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications & Growth Outcome

Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications & Growth Outcome

Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy

Adverse Effect of Preoperative Steroid Use on Surgical Outcomes

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Risk of peri-operative complications in children receiving preoperative steroids

Cited by 3 publications

References 40 publications

Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications &amp; Growth Outcome

Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications &amp; Growth Outcome

Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy

Adverse Effect of Preoperative Steroid Use on Surgical Outcomes

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Product

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Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications & Growth Outcome

Clinical Outcomes After Gastrostomy Tube Removal in Children: Risk Factors for Complications & Growth Outcome