Preoperative Corticosteroid Use for Medical Conditions is Associated with Increased Postoperative Infectious Complications and Readmissions After Total Hip Arthroplasty: A Propensity-Matched Study

December 10, 2018 | Surgery

Venkat Boddapati, BA ; Michael C. Fu, MD, MHS ; Edwin P. Su, MD ; Peter K. Sculco, MD ; Stefano A. Bini, MD ; David J. Mayman, MD

TAKE-HOME POINTS

The rate of preoperative corticosteroid usage is low (3.7%).
Patients using preoperative corticosteroids had increased rates of total 30-day complications.
Adverse outcomes that are increased include infectious complications (eg, sepsis, urinary tract infection, surgical site infection).
Hospital readmissions are also increased in patients taking preoperative corticosteroids, with the most common reason being infection.
Increased postoperative counseling and surveillance may be warranted in this patient population.

CONCLUSION

In conclusion, this study quantified the increased risk for perioperative complications and hospital readmissions in patients who chronically use corticosteroids and are undergoing THA, when compared with those who do not use corticosteroids. These results suggest that patients who are on long-term steroids are at an increased risk for complications, primarily infectious complications. This finding has important implications for patient counseling, preoperative risk stratification, and suggests that higher risk patients, such as chronic steroid users, may benefit from improved discharge care to decrease complication rates.

References