Effect of high-dose dexamethasone on perioperative lactate levels and glucose control: a randomized controlled trial

Table 3 Postoperative outcomes in the dexamethasone and placebo groups

Outcome measure^a	Dexamethasone	Placebo	P value
Glucose AUC₁₅ in mmol/L × hour	126.5 (13.0)	114.4 (13.9)	<0.001
Glucose level in mmol/L at postoperative ICU admission	8.7 (2.3)	6.9 (2.0)	<0.001
Hyperglycemic index in mmol/L^b (cutoff >6.0 mmol/L)	1.97 (0.85)	1.28 (0.81)	<0.001
Hyperglycemic index in mmol/L^c (cutoff >8.0 mmol/L)	0.74 (0.69)	0.35 (0.51)	<0.001
Hypoglycemia incidence, N (%)^d	3 (1.2)	20 (8.0)	<0.001
Lactate AUC₁₅ in mmol/L × hour	25.8 (13.1)	19.9 (11.2)	<0.001
Lactate level in mmol/L at postoperative ICU admission	2.1 (1.0)	1.6 (0.7)	<0.001
Insulin consumption in IU at first 15 hours of ICU admission	32.0 (19.9)	16.3 (14.5)	<0.001
ICU length of stay in hours, median (IQR)	21.9 (19.3-23.7)	22.7 (20.6-45.0)	0.001
ICU length of stay ≥24 hours, N (%)	62 (25.0)	98 (39.2)	0.001
ICU readmissions, N (%)	13 (5.2)	10 (4.0)	0.51
Hospital length of stay in days, median (IQR)	10 (8-16)	11 (8-16)	0.53
Postoperative inotropic or vasopressor requirement, N (%)	125 (50.6)	144 (57.6)	0.14
Postoperative surgical site infections, N (%)	5 (2.0)	6 (2.4)	0.77
Postoperative gastrointestinal hemorrhage, N (%)	3 (1.2)	1 (0.4)	0.37
30-day mortality, N (%)^e	4 (1.6)	6 (2.4)	0.76

To convert glucose to mg/dL, multiply by 18.02. To convert lactate to mg/dL, multiply by 9.01. ^aAll data refer to the first 15 postoperative hours and are presented as mean (standard deviation) unless otherwise indicated. ^bCalculated by dividing the part of the glucose AUC₁₅ (area under the curve in the first 15 hours of postoperative intensive care unit stay) that lies above 6.0 mmol/L by observation time. ^cCalculated by dividing the part of the glucose AUC₁₅ that lies above 8.0 mmol/L by observation time. ^dDefined as any glucose level of less than 4.0 mmol/L in the first 15 postoperative hours. ^eDefined as any use of adrenalin, noradrenalin, dopamine, dobutamine, or milrinone during the first 24 hours of intensive care unit stay. ICU, intensive care unit; IQR, interquartile range.

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