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Association between propofol dose and 1-year mortality in patients with or without a diagnosis of solid cancer.
- Source :
-
British journal of anaesthesia [Br J Anaesth] 2020 Mar; Vol. 124 (3), pp. 271-280. Date of Electronic Publication: 2020 Jan 03. - Publication Year :
- 2020
-
Abstract
- Background: Preclinical data suggest suppression of cancer proliferation by propofol, and retrospective studies suggest improved survival after cancer surgery with propofol-based anaesthesia.<br />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 <superscript>-1</superscript> ) as primary and diagnosis of solid cancer as co-primary exposure, and 1-yr mortality as the primary outcome.<br />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 <superscript>-1</superscript> ; 95% confidence interval [CI]: 0.89-0.98; absolute risk reduction fifth vs first quintile 0.5%; 95% CI: 0.2-0.7). This association was modified by a diagnosis of solid cancer (P<0.001 for interaction). Increasing propofol dose was associated with reduced odds of 1-yr mortality in patients without solid cancer (aOR: 0.78; 95% CI: 0.71-0.85), but not in patients with solid cancer (0.99; 0.94-1.04), a finding that was replicated when examining 5-yr mortality.<br />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.<br /> (Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Male
Massachusetts epidemiology
Middle Aged
Postoperative Complications mortality
Retrospective Studies
Survival Analysis
Anesthesia, General methods
Anesthetics, Intravenous administration & dosage
Neoplasms mortality
Postoperative Complications prevention & control
Propofol administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1471-6771
- Volume :
- 124
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- British journal of anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 31902588
- Full Text :
- https://doi.org/10.1016/j.bja.2019.11.028