Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery
| Autor: | Eleni Panagoulas, Rajasekar Natarajan, Graeme Michael Downes, DEVENDER MITTAPALLI, Vincent Quan, Guy Stanley, James Fitzgerald, Vasileios Gkiousias, John O'Callaghan, Thomas Tilston, Rebecka Ahl Hulme, Nader Hanna, Muhammad Fadhlillah, Chiraag Thakrar Karia, James Kilgour, Chetan Khatri, Benjamin Turner, Vin Shen Ban, Fiqry Fadhlillah, Keith Dear, Christine Hanna, Dominic Marshall, Andrew Beamish, Cameron Brown, Zainab Rai, STARSurg Collaborative, Simon Timbrell, Vasilis Panayi, Joshua Burke, Philip Spreadborough, James Glasbey, Priyadharshanan Ariyaratnam, Ewen Harrison, Liam Yapp, Adam Hague, Haider Shah, Sarah Gentry, Chia Yew Kong, Dr Rochelle Velho MBChB MPH (Merit) BSc (Hons), Mark Tan, Zahra Jaffry, Ian Henderson, Michael Kelly, David Naumann, Hannah Ruth Panayiotou, Stephen Chapman, Chiraag Thakrar, Lucie Ferguson, Jaideep Sharma, Liam Couch, Ewan Kennedy, Hew David Torrance, Kirtan Patel |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal Diseases Logistic regression Postoperative Complications medicine Humans Propensity Score Adverse effect Emergency Treatment Postoperative Care business.industry Anti-Inflammatory Agents Non-Steroidal Odds ratio Length of Stay Middle Aged Colorectal surgery Confidence interval Surgery Treatment Outcome Elective Surgical Procedures Anesthesia Propensity score matching Regression Analysis Female Observational study Elective Surgical Procedure business |
| Zdroj: | British Journal of Surgery. 101:1413-1423 |
| ISSN: | 1365-2168 0007-1323 |
| Popis: | Background Recent evidence has suggested an association between postoperative non-steroidal anti-inflammatory drugs (NSAIDs) and increased operation-specific complications. This study aimed to determine the safety profile following gastrointestinal surgery across a multicentre setting in the UK. Methods This multicentre study was carried out during a 2-week interval in September–October 2013. Consecutive adults undergoing elective or emergency gastrointestinal resection were included. The study was powered to detect a 10 per cent increase in major complications (grade III–V according to the Dindo–Clavien classification). The effect of administration of NSAIDs on the day of surgery or the following 2 days was risk-adjusted using propensity score matching and multivariable logistic regression to produce adjusted odds ratios (ORs). The type of NSAID and the dose were registered. Results Across 109 centres, early postoperative NSAIDs were administered to 242 (16·1 per cent) of 1503 patients. Complications occurred in 981 patients (65·3 per cent), which were major in 257 (17·1 per cent) and minor (Dindo–Clavien grade I–II) in 724 (48·2 per cent). Propensity score matching created well balanced groups. Treatment with NSAIDs was associated with a reduction in overall complications (OR 0·72, 95 per cent confidence interval 0·52 to 0·99; P = 0·041). This effect predominately comprised a reduction in minor complications with high-dose NSAIDs (OR 0·57, 0·39 to 0·89; P = 0·009). Conclusion Early use of NSAIDs is associated with a reduction in postoperative adverse events following major gastrointestinal surgery. |
| Databáze: | OpenAIRE |
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