Perioperative IV dexamethasone decreased risk for pulmonary embolism, DVT after TJA
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Key takeaways:
- Dexamethasone was associated with decreased risks for thrombotic disorders after total joint arthroplasty.
- Administration of dexamethasone decreased risks for pulmonary embolism and deep vein thrombosis.
According to published results, perioperative IV dexamethasone was associated with decreased risk for pulmonary embolism and deep vein thrombosis after total joint arthroplasty for patients with a history of venous thromboembolism.
Researchers analyzed data from 70,147 patients who underwent total hip or knee arthroplasty with (n = 40,607; 57.89%) vs. without (n = 29,540; 42.11%) the administration of perioperative IV dexamethasone from 2015 to 2021. Outcome measures included length of stay (LOS), incidence of pulmonary embolism, incidence of DVT, 90-day complications, readmissions and in-hospital mortalities.
Researchers found patients who received dexamethasone had significantly shorter LOS (1.8 days vs. 2.2 days), as well as significantly lower rates of pulmonary embolism (1.37% vs. 1.75%), DVT (2.37% vs. 3.01%), 90-day readmission (3.74% vs. 4.44%) and 90-day in-hospital mortality (0.13% vs. 0.21%) compared with patients who did not receive dexamethasone.
Researchers concluded patients who received dexamethasone were at a lower risk for pulmonary embolism (adjusted OR = 0.78) and DVT (aOR = 0.84) compared with patients who did not receive dexamethasone.
“These data warrant further study but should provide confidence to arthroplasty surgeons that perioperative dexamethasone administration has the potential to decrease thromboembolic complications without an increased risk of infection, even in high-risk [venous thromboembolism] patients undergoing TJA,” the researchers wrote.
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