Postoperative leukocyte changes in facial fracture patients: a randomized prospective study with short-term dexamethasone

Johanna Snäll, Jyrki Johannes Törnwall, Anna-Liisa Suominen, Hanna Thoren

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Purpose We investigated leukocyte changes in facial fracturepatients undergoing surgery. Of specific interest was the effectof perioperative dexamethasone on leukocyte changes.Methods Facial fracture patients were randomized to receiveperioperatively a total dose of 30 mg of dexamethasone,whereas patients in the control group received no glucocorticoid.All patients received antibiotics until postoperative days7–10. Leukocyte count was measured on postoperative days 1and 2. Clinical infections were observed during the follow-up.Results A total of 110 adult patients were included in thestudy. Postoperative leukocytosis was found in 91.2% of patientsreceiving dexamethasone and in 67.9% of controls.Dexamethasone was associated strongly with leukocyte rise(p < 0.001) on both postoperative days. Transoral surgery andyounger age (≤40 years) showed significant associations withleukocytosis on the first postoperative day (p = 0.002). Inregression analyses, dexamethasone associated with leukocytosismost significantly (p < 0.001). No association was foundwith infections.Conclusions Dexamethasone use was the most significantpredictor of leukocyte rise. As a drug response, perioperativedexamethasone caused sixfold postoperative leukocytosis.High-dose dexamethasone-induced leukocytosis may confusethe clinical decision-making especially in assessment of earlyinfections
Original languageEnglish
JournalOral and Maxillofacial Surgery
Volume21
Issue number2
Pages (from-to)241-246
ISSN1865-1550
DOIs
Publication statusPublished - Jun 2017
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 3126 Surgery, anesthesiology, intensive care, radiology
  • 3111 Biomedicine

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