IN BRIEF

Preoperative high-dose dexamethasone in emergency laparotomy

This trial randomised 120 patients undergoing emergency laparotomy to preoperative dexamethasone or placebo. The steroid group had a lower CRP response on day 1, improved recovery and a lower 90-day mortality (7% vs 23%). Authors concluded that single high-dose steroids reduced inflammatory response and improved outcomes.

Cihoric M, Kehlet H, Lauritsen ML, et al. Br J Surg 2024; 111(7), July 24.

The ‘Global Surgical-Site Infection’ predictive model in GI surgery

This study developed a score to predict 30-day surgical-site infection after GI surgery by secondary analysis of GlobalSurg-1 and GlobalSurg-2 cohort studies. 14,019 patients were used for derivation and 8,464 for validation. The final score included: country income, ASA grade, diabetes, operative contamination, approach and duration. Authors concluded this could be used globally to modify the risk and harm of surgical-site infections.

NIHR Global Research Health Unit on Global Surgery and GlobalSurg Collaborative. Br J Surg 2024; 11(6), June 24.

Incidence of ERCP after subtotal cholecystectomy

This retrospective study looked at 87 patients (7%) who had a subtotal cholecystectomy (SC). They were more likely to be male, older and higher ASA. ERCP was 10 times more likely with SC, and less likely in reconstituting than fenestrating SC.

Nordness M, Smith M, Fogel J, et al. J AM Coll Surg 2024; 239(2): b145.

Association of Surgeon Self-Reported Gender and Surgical Outcomes in Current US Practice

This study looked at surgeon gender and a primary clinical outcome of death/ complications/readmission for 39 operations. Around 12,000 female surgeons and 24,000 male surgeons operated on 4,882,784 patients. After matching the primary outcome occurred in 13% of patients (12.9% female, 13% male), with female surgeons having a small association with lower mortality. Authors concluded that surgeon gender alone does not have a clinically meaningful impact on patient outcomes.

Scali S, Columbo J, Hawn M, et al. Ann Surg 2024; 280(3): b480.

Low-Dose Aspirin Is the Safest Prophylaxis for Prevention of Thromboembolism After Total Knee Arthroplasty 

This study used a national database to evaluate patients undergoing TKA who received low-dose aspirin versus other chemoprophylaxis between 2012 and 2022. 126,692 patients undergoing TKA were included. Both low-risk and high-risk patients in the low-dose aspirin-only cohorts had decreased odds of DVT, PE, bleeding, infections and hospitalisations compared with other prophylaxis regimens. Authors concluded that the study shows low-dose aspirin is a safe and effective method of prophylaxis in patients across various risk profiles.

Lavu, MS, Porto JR, Hecht CJ, et al. The Journal of Bone and Joint Surgery 2024; 106(14):p 1256.