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July 10, 1995

Low Complication Rate of Corticosteroid-Treated Asthmatics Undergoing Surgical Procedures

Author Affiliations

From the Divisions of Allergy-Immunology (Drs Kabalin and Grammer) and General Internal Medicine (Dr Yarnold), Department of Medicine, and the Ernest S. Bazley Asthma and Allergic Diseases Center of Northwestern Memorial Hospital and Northwestern University, Northwestern University Medical School, Chicago, Ill; and the Department of Psychology, University of Illinois at Chicago (Dr Yarnold).

Arch Intern Med. 1995;155(13):1379-1384. doi:10.1001/archinte.1995.00430130053006

Objective:  To determine the incidence of perioperative complications in asthmatic patients who received preoperative treatment with corticosteroids and whether these could be predicted using any study variables such as age, sex, severity of asthma, or surgery type.

Methods:  Using a retrospective cohort design, we studied 71 asthmatic patients who underwent 89 surgical procedures; 86 of 89 patients received preoperative treatment with systemic corticosteroids. The main outcome measures evaluated were incidence of postoperative bronchospasm, infection, clinical evidence of adrenocortical insufficiency, and death.

Results:  Three patients (4.5%) developed mild postoperative bronchospasm; five (5.6%) developed postoperative infections, two of which were wound infections (2.2%); there were no patients with evidence of adrenocortical insufficiency; there was one death related to a neurosurgical intraoperative complication. Incidence of infection was not statistically different from two comparison surgical groups. None of the complications was predicted using any of the study variables.

Conclusion:  Asthmatic patients who are treated preoperatively with corticosteroids can undergo surgical procedures with a low incidence of complications.(Arch Intern Med. 1995;155:1379-1384)