Association between propofol dose and 1-year mortality in patients with or without a diagnosis of solid cancer.

Adult Aged Anesthesia, General / methods Anesthetics, Intravenous / administration & dosage Dose-Response Relationship, Drug Female Follow-Up Studies Humans Male Massachusetts / epidemiology Middle Aged Neoplasms / mortality Postoperative Complications / mortality Propofol / administration & dosage Retrospective Studies Survival Analysis
cancer electronic medical record general anaesthesia mortality propofol retrospective analysis risk reduction behaviour

Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
03 2020
Historique:
received: 13 08 2019
revised: 12 11 2019
accepted: 29 11 2019
pubmed: 7 1 2020
medline: 29 2 2020
entrez: 7 1 2020
Statut: ppublish

Résumé

Preclinical data suggest suppression of cancer proliferation by propofol, and retrospective studies suggest improved survival after cancer surgery with propofol-based anaesthesia. To determine whether propofol dose administered for anaesthesia is associated with 1-yr mortality in patients with and without a diagnosis of solid cancer, we analysed adult patients undergoing monitored anaesthesia care or general anaesthesia at two academic medical centres in Boston, MA, USA. Logistic regression with interaction term analysis was applied with propofol dose (mg kg Of 280 081 patient cases, 10 744 (3.8%) died within 1 yr. Increasing propofol dose was associated with reduced odds of 1-yr mortality (adjusted odds ratio [aOR] 0.93 per 10 mg kg Increasing propofol dose is associated with lower 1-yr mortality in patients without, but not in patients with, a diagnosis of solid cancer. We found evidence for competing effects, modifying the association between propofol dose and mortality.

Sections du résumé

BACKGROUND
Preclinical data suggest suppression of cancer proliferation by propofol, and retrospective studies suggest improved survival after cancer surgery with propofol-based anaesthesia.
METHODS
To determine whether propofol dose administered for anaesthesia is associated with 1-yr mortality in patients with and without a diagnosis of solid cancer, we analysed adult patients undergoing monitored anaesthesia care or general anaesthesia at two academic medical centres in Boston, MA, USA. Logistic regression with interaction term analysis was applied with propofol dose (mg kg
RESULTS
Of 280 081 patient cases, 10 744 (3.8%) died within 1 yr. Increasing propofol dose was associated with reduced odds of 1-yr mortality (adjusted odds ratio [aOR] 0.93 per 10 mg kg
CONCLUSIONS
Increasing propofol dose is associated with lower 1-yr mortality in patients without, but not in patients with, a diagnosis of solid cancer. We found evidence for competing effects, modifying the association between propofol dose and mortality.

Identifiants

DOI: 10.1016/j.bja.2019.11.028 PMID: 31902588
pubmed: 31902588
pii: S0007-0912(19)30933-X
doi: 10.1016/j.bja.2019.11.028
pii:
doi:

Substances chimiques

Anesthetics, Intravenous 0
Propofol YI7VU623SF

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

271-280

Informations de copyright

Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Maximilian S Schaefer (MS)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Anaesthesiology, Duesseldorf University Hospital, Duesseldorf, Germany.

Dana Raub (D)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Xinling Xu (X)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Center for Anesthesia Research Excellence, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

Denys Shay (D)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Bijan Teja (B)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

Khushi Chhangani (K)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Stephanie D Grabitz (SD)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

Brian O'Gara (B)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

Peter Kienbaum (P)

Department of Anaesthesiology, Duesseldorf University Hospital, Duesseldorf, Germany.

Timothy T Houle (TT)

Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Giovanni Landoni (G)

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Matthias Eikermann (M)

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Anaesthesiology and Intensive Care Medicine, University of Duisburg-Essen, Essen, Germany. Electronic address: meikerma@bidmc.harvard.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Association between propofol dose and 1-year...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Association between propofol dose and 1-year...
questionsmedicales.fr › Anesthésie et analgésie › Anesthésie › Anesthésie générale › Association between propofol dose and 1-year...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Dépresseurs du système nerveux central › Anesthésiques › Anesthésiques généraux › Anesthésiques intraveineux › Association between propofol dose and 1-year...
questionsmedicales.fr › Phénomènes physiologiques › Phénomènes pharmacologiques et toxicologiques › Phénomènes toxicologiques › Relation dose-effet des médicaments › Association between propofol dose and 1-year...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Association between propofol dose and 1-year...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Association between propofol dose and 1-year...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › États-Unis › Nouvelle-Angleterre › Massachusetts › Association between propofol dose and 1-year...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Association between propofol dose and 1-year...
questionsmedicales.fr › Tumeurs › Association between propofol dose and 1-year...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Association between propofol dose and 1-year...
questionsmedicales.fr › Composés chimiques organiques › Hydrocarbures › Hydrocarbures cycliques › Hydrocarbures aromatiques › Dérivés du benzène › Phénols › Propofol › Association between propofol dose and 1-year...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Association between propofol dose and 1-year...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Association between propofol dose and 1-year...