title: Impact of chronic steroid use on outcomes of colorectal surgery.
abstract: BACKGROUND
  Steroid use has been recognized as a factor which has various effects on multiple organs. We aim to investigate the association between chronic steroid use and postoperative complications after colorectal surgery.
  
  
  METHODS
  The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing colorectal resection during 2005 to 2013. Multivariate regression analysis was performed to investigate outcomes of patients with chronic steroid use.
  
  
  RESULTS
  We sampled a total of 147,121 patients who underwent colorectal resection. Of these, 11,195 (7.6%) had a history of chronic steroid use. Patients who had chronic steroid use had a higher risk of preoperative sepsis (adjusted odds ratio [AOR]: 1.41, P < .01), hypoalbuminemia (AOR: 1.49, P < .01), bleeding disorders (AOR: 1.54, P < .01), and diabetes (AOR: 1.11, P = .01). Chronic steroid use was associated with a significant increase in the mortality and morbidity of patients (AOR: 1.56 and 1.25, respectively, P < .01).
  
  
  CONCLUSIONS
  Patients with a chronic steroid use have a high risk of preoperative malnutrition, diabetes, bleeding disorders, and sepsis. A history of chronic steroid use was associated with a significant increase in the mortality and morbidity of patients.
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Irvine, CA 92868, USA.
authors.forename: Zhobin
authors.initials: Z
authors.lastname: Moghadamyeghaneh
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Irvine, CA 92868, USA.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Hanna
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Irvine, CA 92868, USA.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Blondet
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Irvine, CA 92868, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Carmichael
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Irvine, CA 92868, USA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Mills
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Irvine, CA 92868, USA.
authors.forename: Alessio
authors.initials: A
authors.lastname: Pigazzi
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Irvine, CA 92868, USA. Electronic address: mstamos@uci.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D003107:Colorectal Surgery; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D013256:Steroids / Q000008:administration & dosage*; D014481:United States / Q000453:epidemiology
chemical_list: D013256:Steroids
keywords: Chronic steroid use; Colorectal surgery; Corticosteroid drugs