Trial reportBMJ (Clinical research ed.)2021
Effect of dexamethasone on complications or all cause mortality after major non-cardiac surgery: multicentre, double blind, randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Perioperative Administration of Dexamethasone on Postoperative Complications and Mortality After Non-cardiac Major Surgery : a Randomized, Multicentre, Double Blind, Study
The Effect of Perioperative DEXamethasone on Postoperative Complications After PANcreaticoduodenectomy
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Inappropriate Evaluation of Effect Modifications Based on Categorical Outcomes: A Systematic Review of Randomized Controlled Trials.International journal of environmental research and public health · 2022Pooled it
- Dexamethasone vs. placebo modulation of the perioperative blood immune proteome in patients undergoing total knee arthroplasty.BMC anesthesiology · 2025Trial
- Effect of Perineural or Intravenous Betamethasone on Femoral Nerve Block Outcomes in Knee Arthroplasty: A Randomized, Controlled Study.Orthopaedic surgery · 2024Trial
- Optimizing perioperative systemic dexamethasone use in total knee arthroplasty: a narrative review on current evidence.Knee surgery & related research · 2026Review
- Article
- Association Between Preoperative Single Dose of Dexamethasone and Postoperative Outcomes in Elderly Patients with Gastric Cancer.Drug design, development and therapy · 2026Article
- High-dose glucocorticoids: improving outcomes of emergency laparotomy by reducing inflammation.The British journal of surgery · 2024Article
- Article
- Article
- Rational Multimodal Analgesia for Perioperative Pain Management.Current pain and headache reports · 2023Review
- Postoperative systemic inflammatory dysregulation and corticosteroids: a narrative review.Anaesthesia · 2023Review
- Volume Incentive Spirometry Reduces Pulmonary Complications in Patients After Open Abdominal Surgery: A Randomized Clinical Trial.International journal of general medicine · 2023Article
- Multimodal Analgesia in the Aesthetic Plastic Surgery: Concepts and Strategies.Plastic and reconstructive surgery. Global open · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
27 authors at 17 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the effect of dexamethasone on complications or all cause mortality after major non-cardiac surgery.
designPhase III, randomised, double blind, placebo controlled trial.
setting34 centres in France, December 2017 to March 2019.
participants1222 adults (>50 years) requiring major non-cardiac surgery with an expected duration of more than 90 minutes. The anticipated time frame for recruitment was 24 months.
interventionsParticipants were randomised to receive either dexamethasone (0.2 mg/kg immediately after the surgical procedure, and on day 1) or placebo. Randomisation was stratified on the two prespecified criteria of cancer and thoracic procedure. MAIN OUTCOMES MEASURES: The primary outcome was a composite of postoperative complications or all cause mortality within 14 days after surgery, assessed in the modified intention-to-treat population (at least one treatment administered).
resultsOf the 1222 participants who underwent randomisation, 1184 (96.9%) were included in the modified intention-to-treat population. 14 days after surgery, 101 of 595 participants (17.0%) in the dexamethasone group and 117 of 589 (19.9%) in the placebo group had complications or died (adjusted odds ratio 0.81, 95% confidence interval 0.60 to 1.08; P=0.15). In the stratum of participants who underwent non-thoracic surgery (n=1038), the primary outcome occurred in 69 of 520 participants (13.3%) in the dexamethasone group and 93 of 518 (18%) in the placebo group (adjusted odds ratio 0.70, 0.50 to 0.99). Adverse events were reported in 288 of 613 participants (47.0%) in the dexamethasone group and 296 of 609 (48.6%) in the placebo group (P=0.46).
conclusionsDexamethasone was not found to significantly reduce the incidence of complications and death in patients 14 days after major non-cardiac surgery. The 95% confidence interval for the main result was, however, wide and suggests the possibility of important clinical effectiveness.
trial registrationClinicalTrials.gov NCT03218553.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.