{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,6]],"date-time":"2024-10-06T00:44:03Z","timestamp":1728175443379},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,1,29]],"date-time":"2014-01-29T00:00:00Z","timestamp":1390953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A number of perioperative risk factors may suppress the immune system and contribute to the development of post\u2010operative complications. The association between surgical site infection (<jats:styled-content style=\"fixed-case\">SSI<\/jats:styled-content>) and other wound\u2010related complications resulting from immunosuppression through either perioperative administration of dexamethasone, pre\u2010operative smoking or alcohol abuse is, however, uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a post hoc analysis of data from the <jats:styled-content style=\"fixed-case\">PROXI<\/jats:styled-content> randomized trial in 1386 patients who underwent emergency or elective laparotomy. We assessed the associations of use of dexamethasone, smoking status and alcohol abuse with the primary outcome, being a composite of <jats:styled-content style=\"fixed-case\">SSI<\/jats:styled-content>, anastomotic leak, wound dehiscence, burst abdomen and 30\u2010day mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The primary outcome occurred in 21% of patients receiving dexamethasone versus 28% of patients not receiving dexamethasone, and this was not statistically significant when adjusting for stratification variables originally used in the <jats:styled-content style=\"fixed-case\">PROXI<\/jats:styled-content> trial [OR 0.90, 95% CI (0.65\u20131.24)]. In smokers, the primary outcome occurred in 32%, compared with 23% of non\u2010smokers (<jats:italic>P<\/jats:italic>\u2009=\u20090.0001). Smokers also had a higher frequency of <jats:styled-content style=\"fixed-case\">SSI<\/jats:styled-content> (25% vs 17%, <jats:italic>P\u2009<\/jats:italic>&lt;<jats:italic>\u2009<\/jats:italic>0.0001) and burst abdomen (3.8% vs 2.4%, <jats:italic>P<\/jats:italic>\u2009=\u20090.04). In alcohol abusers, the primary outcome occurred in 48%, compared with 25% in patients who did not abuse alcohol (<jats:italic>P<\/jats:italic>\u2009=\u20090.0006). Burst abdomen occurred more commonly in alcohol abusers (15% vs 2.3%, <jats:italic>P\u2009<\/jats:italic>&lt;<jats:italic>\u2009<\/jats:italic>0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Perioperative administration of dexamethasone was not significantly associated with SSI or other wound\u2010related complications. Conversely, smoking and alcohol abuse were both significant predictors of the primary outcome consisting of wound\u2010related complications and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12270","type":"journal-article","created":{"date-parts":[[2014,1,29]],"date-time":"2014-01-29T08:14:45Z","timestamp":1390983285000},"page":"352-361","source":"Crossref","is-referenced-by-count":24,"title":["The association of perioperative dexamethasone, smoking and alcohol abuse with wound complications after laparotomy"],"prefix":"10.1111","volume":"58","author":[{"given":"RIKKE M.","family":"DAHL","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Herlev Hospital University of Copenhagen  Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00d8RN","family":"WETTERSLEV","sequence":"additional","affiliation":[{"name":"Copenhagen Trial Unit Centre for Clinical Intervention Research  Copenhagen 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