Background
Methods
Subjects
Data collection
Statistical analyses
Results
Subjects
Patients’ demographic data
Non-dexamethasone (N = 2392) | Dexamethasone (N = 236) | P-value | |
---|---|---|---|
Demographic data | |||
Age (years) | 50.1 ± 10.3 | 49.5 ± 9.3 | 0.418 |
BMI (kg m−2) | 23.3 ± 3.1 | 23.4 ± 3.1 | 0.764 |
Comorbidity | |||
HTN | 473 (19.8) | 44 (18.6) | 0.732 |
DM | 172 (7.2) | 14 (5.9) | 0.594 |
Cardiac disease | 60 (2.5) | 4 (1.7) | 0.656 |
Pulmonary disease | 46 (1.9) | 6 (2.5) | 0.463 |
Endocrine disease | 109 (4.6) | 14 (5.9) | 0.332 |
Renal disease | 16 (0.7) | 1 (0.4) | > 0.999 |
Liver disease | 16 (0.7) | 2 (0.8) | 0.673 |
Neurological disease | 40 (1.7) | 4 (1.7) | > 0.999 |
Others | 14 (0.6) | 3 (1.3) | 0.191 |
Anaesthetic factors | |||
Anaesthetic agent | 0.001 | ||
Volatiles | |||
Sevoflurane | 1461 (61.1) | 141 (59.7) | |
Desflurane | 613 (25.6) | 47 (19.9) | |
Isoflurane | 242 (10.1) | 27 (11.4) | |
Enflurane | 31 (1.3) | 10 (4.2) | |
TIVA | 45 (1.9) | 11 (4.7) | |
Induction agents | 0.029 | ||
Propofol | 1856 (77.6) | 168 (71.2) | |
Barbiturate | 536 (22.4) | 68 (28.8) | |
N2O | 176 (7.4) | 28 (11.9) | 0.021 |
Premedicationa | 1585 (66.3) | 169 (71.6) | 0.111 |
Antiemetic | 2069 (86.5) | 180 (76.3) | < 0.001 |
Rescue analgesics | 2297 (96.0) | 225 (95.3) | 0.602 |
Hypertensive events | 145 (6.1) | 15 (6.4) | 0.886 |
Hypotensive events | 343 (14.3) | 25 (10.6) | 0.140 |
Colloid administration | 36 (1.5) | 6 (2.5) | 0.267 |
RBC transfusion | 12 (0.5) | 0 (0) | 0.616 |
Surgical factors | |||
Surgical procedure | 0.014 | ||
BCS | 1156 (48.3) | 94 (39.8) | |
Mastectomy | 1218 (51.7) | 170 (60.2) | |
Surgical duration (min) | 207.2 ± 131.0 | 212.5 ± 108.5 | 0.487 |
TNM staging | 0.974 | ||
1 | 1126 (47.1) | 113 (47.9) | |
2 | 876 (36.7) | 86 (36.4) | |
3 | 387 (16.2) | 37 (15.7) | |
Receptors | |||
Oestrogen | 1652 (69.1) | 173 (73.3) | 0.183 |
Progesterone | 1506 (63.0) | 151 (64.0) | 0.778 |
HER2 | 658 (27.5) | 60 (25.4) | 0.540 |
Histological analysis | 0.118 | ||
Well-differentiated | 508 (21.2) | 48 (20.3) | |
Moderately differentiated | 1058 (44.2) | 105 (44.5) | |
Poorly differentiated | 584 (24.4) | 48 (20.3) | |
Others | 242 (10.1) | 35 (14.8) | |
Tumour types | 0.818 | ||
IDC | 2105 (88.0) | 212 (87.7) | |
ILC | 85 (3.6) | 10 (4.2) | |
Others | 202 (8.4) | 19 (8.1) | |
Chemotherapy | 1619 (67.7) | 179 (75.8) | 0.010 |
Radiotherapy | 1559 (65.2) | 137 (58.1) | 0.032 |
Risk factors for postoperative recurrence in breast cancer surgery
Variables | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
HR | 95% CI | P-value | HR | 95% CI | P-value | |||
Dexamethasone | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.348 | 0.912 | 1.994 | 0.134 | 1.442 | 0.969 | 2.145 | 0.071 |
Age | 0.989 | 0.976 | 1.002 | 0.089 | ||||
Age (years) | ||||||||
< 40 | 1 (ref) | 1 (ref) | ||||||
40–49 | 0.673 | 0.469 | 0.967 | 0.032 | 0.866 | 0.598 | 1.254 | 0.447 |
50–59 | 0.705 | 0.482 | 1.032 | 0.072 | 0.779 | 0.526 | 1.154 | 0.213 |
60–69 | 0.665 | 0.421 | 1.05 | 0.080 | 0.703 | 0.416 | 1.188 | 0.188 |
≥70 | 0.563 | 0.254 | 1.249 | 0.158 | 0.591 | 0.247 | 1.414 | 0.237 |
BMI | 0.99 | 0.948 | 1.034 | 0.654 | ||||
BMI (kg m−2) | ||||||||
< 18.4 | 1.033 | 0.523 | 2.039 | 0.927 | 0.835 | 0.421 | 1.658 | 0.607 |
18.4–22.9 | 1 (ref) | 1 (ref) | ||||||
23–24.9 | 1.026 | 0.739 | 1.423 | 0.880 | 1.100 | 0.791 | 1.530 | 0.572 |
25–29.9 | 1.033 | 0.749 | 1.426 | 0.842 | 1.021 | 0.738 | 1.411 | 0.901 |
≥30 | 0.73 | 0.298 | 1.789 | 0.491 | 0.626 | 0.254 | 1.546 | 0.310 |
HTN | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.952 | 0.686 | 1.322 | 0.770 | 1.045 | 0.714 | 1.531 | 0.820 |
DM | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.132 | 0.700 | 1.832 | 0.612 | 1.158 | 0.681 | 1.968 | 0.588 |
Anaesthetic agents | ||||||||
TIVA | 1 (ref) | 1 (ref) | ||||||
Volatile | 1.247 | 0.550 | 2.830 | 0.597 | 1.072 | 0.470 | 2.441 | 0.869 |
N2O | ||||||||
No | 1 (ref) | |||||||
Yes | 1.325 | 0.879 | 1.997 | 0.179 | ||||
Transfusion | ||||||||
No | 1 (ref) | |||||||
Yes | 2.591 | 0.644 | 10.426 | 0.180 | ||||
Premedicationa | ||||||||
No | 1 (ref) | |||||||
Yes | 0.878 | 0.670 | 1.150 | 0.345 | ||||
Surgical procedure | ||||||||
BCS | 1 (ref) | 1 (ref) | ||||||
Mastectomy | 2.516 | 1.883 | 3.360 | < 0.001 | 1.934 | 1.429 | 2.618 | < 0.001 |
TNM staging | ||||||||
1 | 1 (ref) | 1 (ref) | ||||||
2 | 2.397 | 1.674 | 3.431 | < 0.001 | 1.778 | 1.168 | 2.706 | 0.007 |
3 | 7.395 | 5.217 | 10.48 | < 0.001 | 5.300 | 3.433 | 8.183 | < 0.001 |
Oestrogen receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.576 | 0.443 | 0.748 | < 0.001 | 0.886 | 0.597 | 1.315 | 0.549 |
Progesterone receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.605 | 0.467 | 0.783 | < 0.001 | 0.835 | 0.571 | 1.222 | 0.355 |
Chemotherapy | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 3.265 | 2.213 | 4.818 | < 0.001 | 0.958 | 0.580 | 1.582 | 0.866 |
Radiotherapy | ||||||||
No | 1 (ref) | |||||||
Yes | 1.211 | 0.917 | 1.597 | 0.177 |
Variables | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
HR | 95% CI | P-value | HR | 95% CI | P-value | |||
Dexamethasone | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.251 | 0.822 | 1.903 | 0.295 | 1.389 | 0.904 | 2.132 | 0.133 |
Age | 0.982 | 0.964 | 1.000 | 0.055 | ||||
Age (years) | ||||||||
< 40 | 1 (ref) | 1 (ref) | ||||||
40–49 | 0.736 | 0.466 | 1.162 | 0.188 | 1.053 | 0.655 | 1.690 | 0.832 |
50–59 | 0.572 | 0.347 | 0.944 | 0.029 | 0.614 | 0.364 | 1.037 | 0.068 |
60–69 | 0.685 | 0.361 | 1.301 | 0.248 | 0.603 | 0.289 | 1.258 | 0.177 |
≥70 | 0.613 | 0.186 | 2.017 | 0.421 | 0.453 | 0.126 | 1.628 | 0.225 |
BMI | 0.977 | 0.922 | 1.035 | 0.436 | ||||
BMI (kg m−2) | ||||||||
< 18.4 | 1.349 | 0.542 | 3.358 | 0.520 | 1.477 | 0.585 | 3.730 | 0.409 |
18.4–22.9 | 1 (ref) | 1 (ref) | ||||||
23–24.9 | 1.159 | 0.765 | 1.757 | 0.485 | 1.321 | 0.866 | 2.015 | 0.196 |
25–29.9 | 0.919 | 0.597 | 1.417 | 0.703 | 1.032 | 0.667 | 1.597 | 0.888 |
≥30 | 0.326 | 0.045 | 2.353 | 0.266 | 0.345 | 0.047 | 2.524 | 0.295 |
HTN | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.109 | 0.718 | 1.713 | 0.642 | 1.270 | 0.761 | 2.118 | 0.360 |
DM | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.438 | 0.755 | 2.740 | 0.269 | 1.502 | 0.742 | 3.040 | 0.259 |
Anaesthetic agents | ||||||||
TIVA | 1 (ref) | 1 (ref) | ||||||
Volatile | 0.575 | 0.235 | 1.406 | 0.225 | 0.782 | 0.312 | 1.960 | 0.600 |
N2O | ||||||||
No | 1 (ref) | |||||||
Yes | 1.515 | 0.919 | 2.497 | 0.103 | ||||
Transfusion | ||||||||
No | 1 (ref) | |||||||
Yes | 1.894 | 0.265 | 13.547 | 0.525 | ||||
Premedicationa | ||||||||
No | 1 (ref) | |||||||
Yes | 0.873 | 0.611 | 1.249 | 0.458 | ||||
Surgical procedure | ||||||||
BCS | 1 (ref) | 1 (ref) | ||||||
Mastectomy | 2.119 | 1.458 | 3.078 | < 0.001 | 1.659 | 1.121 | 2.457 | 0.012 |
TNM staging | ||||||||
1 | 1 (ref) | 1 (ref) | ||||||
2 | 2.454 | 1.503 | 4.006 | < 0.001 | 2.160 | 1.223 | 3.814 | 0.008 |
3 | 8.215 | 5.121 | 13.177 | < 0.001 | 7.780 | 4.303 | 14.064 | < 0.001 |
Oestrogen receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.564 | 0.400 | 0.796 | 0.001 | 0.783 | 0.463 | 1.325 | 0.363 |
Progesterone receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.572 | 0.407 | 0.803 | 0.001 | 0.818 | 0.491 | 1.363 | 0.441 |
Chemotherapy | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.870 | 1.293 | 2.706 | 0.001 | 0.669 | 0.350 | 1.279 | 0.224 |
Radiotherapy | ||||||||
No | 1 (ref) | |||||||
Yes | 1.683 | 1.139 | 2.486 | 0.009 |
Related-factors for postoperative mortality in breast cancer surgery
Variables | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
HR | 95% CI | P-value | HR | 95% CI | P-value | |||
Dexamethasone | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.051 | 0.652 | 1.696 | 0.837 | 1.256 | 0.770 | 2.047 | 0.361 |
Age | 1.028 | 1.013 | 1.042 | < 0.001 | ||||
Age (years) | ||||||||
< 40 | 1 (ref) | 1 (ref) | ||||||
40–49 | 0.586 | 0.369 | 0.931 | 0.024 | 0.772 | 0.480 | 1.240 | 0.285 |
50–59 | 0.852 | 0.539 | 1.346 | 0.493 | 0.922 | 0.575 | 1.479 | 0.736 |
60–69 | 1.175 | 0.716 | 1.929 | 0.523 | 1.151 | 0.654 | 2.027 | 0.625 |
≥70 | 2.713 | 1.534 | 4.798 | < 0.001 | 2.427 | 1.220 | 4.830 | 0.012 |
BMI | 0.993 | 0.947 | 1.041 | 0.758 | ||||
BMI (kg m−2) | ||||||||
< 18.4 | 1.564 | 0.810 | 3.021 | 0.183 | 1.271 | 0.653 | 2.474 | 0.480 |
18.4–22.9 | 1 (ref) | 1 (ref) | ||||||
23–24.9 | 1.14 | 0.788 | 1.649 | 0.488 | 1.180 | 0.813 | 1.715 | 0.384 |
25–29.9 | 1.016 | 0.696 | 1.483 | 0.934 | 0.963 | 0.657 | 1.413 | 0.847 |
≥30 | 1.209 | 0.527 | 2.775 | 0.654 | 1.265 | 0.545 | 2.939 | 0.584 |
HTN | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.564 | 1.128 | 2.166 | 0.007 | 1.048 | 0.703 | 1.563 | 0.817 |
DM | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.810 | 1.148 | 2.852 | 0.0107 | 1.217 | 0.732 | 2.023 | 0.450 |
Anaesthetic agents | ||||||||
TIVA | 1 (ref) | 1 (ref) | ||||||
Volatile | 0.497 | 0.123 | 2.017 | 0.328 | 3.036 | 0.738 | 12.485 | 0.124 |
N2O | ||||||||
No | 1 (ref) | |||||||
Yes | 1.388 | 0.892 | 2.158 | 0.146 | ||||
Transfusion | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 7.527 | 2.792 | 20.296 | < 0.001 | 5.551 | 1.980 | 15.559 | 0.001 |
Premedicationa | ||||||||
No | 1 (ref) | |||||||
Yes | 0.817 | 0.602 | 1.108 | 0.193 | ||||
Surgical procedure | ||||||||
BCS | 1 (ref) | 1 (ref) | ||||||
Mastectomy | 3.073 | 2.169 | 4.355 | < 0.001 | 2.244 | 1.556 | 3.236 | < 0.001 |
TNM staging | ||||||||
1 | ||||||||
2 | 1.902 | 1.275 | 2.838 | 0.002 | 1.591 | 0.994 | 2.545 | 0.053 |
3 | 6.312 | 4.318 | 9.226 | < 0.001 | 5.435 | 3.338 | 8.850 | < 0.001 |
Oestrogen receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.398 | 0.297 | 0.533 | < 0.001 | 0.758 | 0.488 | 1.177 | 0.217 |
Progesterone receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.369 | 0.274 | 0.496 | < 0.001 | 0.565 | 0.367 | 0.870 | 0.010 |
Chemotherapy | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.870 | 1.293 | 2.706 | < 0.001 | 0.674 | 0.403 | 1.128 | 0.133 |
Radiotherapy | ||||||||
No | 1 (ref) | |||||||
Yes | 0.922 | 0.682 | 1.246 | 0.597 |
Variables | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
HR | 95% CI | P-value | HR | 95% CI | P-value | |||
Dexamethasone | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 1.223 | 0.733 | 2.041 | 0.442 | 1.506 | 0.886 | 2.561 | 0.130 |
Age | 1.005 | 0.983 | 1.028 | 0.636 | ||||
Age (years) | ||||||||
< 40 | 1 (ref) | 1 (ref) | ||||||
40–49 | 0.607 | 0.331 | 1.113 | 0.107 | 0.979 | 0.517 | 1.855 | 0.949 |
50–59 | 0.763 | 0.416 | 1.400 | 0.382 | 0.778 | 0.411 | 1.473 | 0.440 |
60–69 | 1.165 | 0.574 | 2.364 | 0.673 | 0.962 | 0.419 | 2.208 | 0.927 |
≥70 | 1.087 | 0.318 | 3.714 | 0.894 | 0.866 | 0.226 | 3.323 | 0.834 |
BMI | 0.991 | 0.925 | 1.063 | 0.810 | ||||
BMI (kg m−2) | ||||||||
< 18.4 | 0.852 | 0.542 | 3.358 | 0.520 | 0.759 | 0.179 | 3.216 | 0.709 |
18.4–22.9 | 1 (ref) | 1 (ref) | ||||||
23–24.9 | 1.449 | 0.765 | 1.757 | 0.485 | 1.647 | 0.994 | 2.730 | 0.053 |
25–29.9 | 1.012 | 0.597 | 1.417 | 0.703 | 1.008 | 0.584 | 1.740 | 0.976 |
≥30 | ||||||||
HTN | ||||||||
No | 1 (ref) | |||||||
Yes | 1.692 | 1.052 | 2.723 | 0.030 | ||||
DM | ||||||||
No | 1 (ref) | |||||||
Yes | 1.775 | 0.858 | 3.672 | 0.122 | ||||
Anaesthetic agents | ||||||||
TIVA | 1 (ref) | 1 (ref) | ||||||
Volatile | 1.050 | 0.258 | 4.272 | 0.946 | 1.400 | 0.332 | 5.892 | 0.647 |
N2O | ||||||||
No | 1 (ref) | |||||||
Yes | 1.523 | 0.840 | 2.763 | 0.166 | ||||
Transfusion | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 6.113 | 1.503 | 24.857 | 0.011 | 3.063 | 0.6900 | 13.600 | 0.141 |
Premedicationa | ||||||||
No | 1 (ref) | |||||||
Yes | 0.796 | 0.515 | 1.231 | 0.305 | ||||
Surgical procedure | ||||||||
BCS | 1 (ref) | 1 (ref) | ||||||
Mastectomy | 2.699 | 1.652 | 4.408 | < 0.001 | 2.289 | 1.367 | 3.833 | 0.002 |
TNM staging | ||||||||
1 | 1 (ref) | 1 (ref) | ||||||
2 | 2.403 | 1.293 | 4.466 | 0.006 | 1.553 | 0.774 | 3.117 | 0.216 |
3 | 8.587 | 4.770 | 15.458 | < 0.001 | 5.509 | 2.732 | 11.106 | < 0.001 |
Oestrogen receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.338 | 0.222 | 0.514 | < 0.001 | 0.699 | 0.374 | 1.305 | 0.261 |
Progesterone receptor | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 0.280 | 0.180 | 0.435 | < 0.001 | 0.428 | 0.228 | 0.803 | 0.008 |
Chemotherapy | ||||||||
No | 1 (ref) | 1 (ref) | ||||||
Yes | 4.667 | 2.156 | 10.103 | < 0.001 | 1.381 | 0.549 | 3.474 | 0.493 |
Radiotherapy | ||||||||
No | 1 (ref) | |||||||
Yes | 1.473 | 0.926 | 2.343 | 0.102 |