Evidence map›Paper›PMID 42530646›Full record

ArticleJournal of anesthesia2026

The effect of intravenous low-dose steroids on post-operative delirium in older adult patients undergoing non-cardiac surgery: a retrospective cohort analysis.

Huan Hsu, Yara Dias, Yi-Wen Chang, Junhui Mi, Liu Liu, Ahmad Al Jarkas, Sam D Gumbert, Jiang Wu, Yian Chen, Ryu Komatsu

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Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

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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.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Huan HsuDepartment of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.
Yara DiasDepartment of Anesthesiology Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
Yi-Wen ChangDepartment of Anesthesiology, Kuang-Tien General Hospital, Taichung, Taiwan.
Junhui MiSection of Biostatistics, Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Liu LiuSection of Biostatistics, Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Ahmad Al JarkasDepartment of Anesthesia, Critical Care and Pain Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA.
Sam D GumbertMulti-Specialty Anesthesiology, Integrated Hospital-Care Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Jiang WuDepartment of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA.
Yian ChenDepartment of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA.
Ryu KomatsuMulti-Specialty Anesthesiology, Integrated Hospital-Care Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA. KOMATSR@ccf.org.ORCID http://orcid.org/0000-0002-3824-8680

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePostoperative delirium (POD) is a common complication in elderly surgical patients, associated with increased mortality and healthcare costs. While high-dose steroids may reduce POD risk in non-cardiac surgeries, infection concerns limit their use. This study assessed whether intraoperative low-dose steroids, commonly used as antiemetics, are associated with lower POD incidence.

methodsWe conducted a retrospective cohort study of patients aged 65 or older who underwent elective non-cardiac surgery at Cleveland Clinic from 2016 to 2024. Patients receiving intraoperative steroids (4-10 mg dexamethasone) were compared to those who did not. Primary outcome was POD within 4 days postoperatively; secondary outcomes included hospital length of stay and infection complications. Logistic and linear regression models were used and adjusted for potential confounders. Additionally, a sensitivity analysis was conducted to examine the interaction between steroids and dementia.

resultsAmong 46,966 patients, 59% received steroids. POD incidence was significantly lower in the steroid administration group (0.6%) versus controls (2.2%) [adjusted odds ratio (aOR): 0.33, 95% confidence interval (CI): 0.25-0.42, P < 0.001], a finding that remained consistent under broader POD definitions (5.1% vs. 8.9%; aOR = 0.76, 95% CI 0.69-0.84, P < 0.001). The benefit was evident in patients without dementia (aOR: 0.73) but not in those with dementia (aOR: 1.18). Steroid administration was also linked to shorter hospital stays (adjusted geometric mean ratio: 0.90, P < 0.001) and fewer postoperative infections (aOR: 0.43, P < 0.001).

conclusionsIntraoperative steroid administration was associated with reduced POD, shorter hospital stays, and fewer infections in elderly patients undergoing elective non-cardiac surgery. These findings support their perioperative use, particularly in patients without preexisting dementia.

Indexed as

ElderlyIntraoperative steroidsLow-dose steroidsNon-cardiac surgeryPostoperative delirium

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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 Socratic graph.