348 Preoperative Steroid Use Increases Complications After Nerve Transfer And Grafting

INTRODUCTION: Preoperative steroids have been implicated in adverse surgical outcomes. This connection has not been studied in nerve pedicle transfer procedures. METHODS: Patients undergoing nerve pedicle transfer surgery were identified using the 2007-2021 American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) dataset. Chi-square analysis was used to analyze the independent impact of steroid use on many postoperative outcomes. T-test was used to analyze preoperative steroid use effect on length of stay. RESULTS: A total of 3209 patients were evaluated, with 69 receiving preoperative steroids. Steroid use was significantly associated with having to return to the operating room (p<0.001), increased blood transfusion (p<0.001), increased deep incisional surgical site infection (p<0.001), pneumonia (p=0.004), pulmonary embolism (p=0.027), urinary tract infection (p=0.043), cardiac arrest (p<0.001), sepsis occurrences (p=0.019), and overall complications (p=0.019, OR 1.874[1.109-3.168]). There was no significant difference in length of hospital stay (p=0.249), superficial incisional surgical site infection (p=0.433), or wound disruption (p=0.522). CONCLUSIONS: Steroid use before nerve pedicle transfer surgery is associated with return to OR, receiving blood transfusions, deep incisional surgical site infections, and increase in overall postoperative complications. It does not affect the length of stay, superficial surgical site infection, or cause wound disruption. These factors can be considered when managing preoperative steroid use in nerve pedicle transfer procedures.