Association of Perioperative Use of Nonsteroidal Anti-Inflammatory Drugs With Postoperative Myocardial Infarction After Total Joint Replacement
| Autor: | Mihai Bieltz, Stavros G. Memtsoudis, Spencer S. Liu, James J. Bae, Yan Ma |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
musculoskeletal diseases Time Factors Arthroplasty Replacement Hip medicine.medical_treatment Myocardial Infarction Knee replacement Risk Assessment Risk Factors Odds Ratio Humans Medicine Myocardial infarction Arthroplasty Replacement Knee Perioperative Period Propensity Score Aged Aged 80 and over Pain Postoperative Chi-Square Distribution business.industry Anti-Inflammatory Agents Non-Steroidal Troponin I Absolute risk reduction General Medicine Odds ratio Perioperative Length of Stay Middle Aged medicine.disease Logistic Models Treatment Outcome Anesthesiology and Pain Medicine Anesthesia Relative risk Propensity score matching Female New York City Myocardial infarction diagnosis business Biomarkers |
| Zdroj: | Regional Anesthesia and Pain Medicine. 37:45-50 |
| ISSN: | 1098-7339 |
| DOI: | 10.1097/aap.0b013e31823354f5 |
| Popis: | Background and Objectives Use of nonsteroidal anti-inflammatory drug (NSAIDs) analgesics is controversial because of cardiovascular risk, but perioperative use may be advantageous for total joint replacement. Thus, we performed this single-center observational cohort study to determine any association between NSAID use and postoperative myocardial infarction (POMI). Methods All patient admissions undergoing total hip or knee replacement between March 3, 2009, and September 1, 2010, were identified. Nonsteroidal anti-inflammatory drug use was identified. Postoperative myocardial infarction was defined as troponin I level greater than 0.1 ng/mL. Propensity scores were calculated to adjust for bias of receiving NSAIDs and troponin measurements. Propensity scores and other covariates were used in logistic regression to determine the independent association of NSAID use with POMI. Results Of the 10,873 arthroplasty admissions, 1518 (14%) had serial troponins measured, and 97 had a POMI (0.9%). Incidence of POMI was 0.8% for the 9,831 who received NSAIDs and 1.8% for the 1,042 (10%) admitted patients who did not receive NSAIDs with a risk difference of −1% with 95% confidence interval (CI) of −0.2% to −1.9%. The adjusted odds ratio (0.95; 95% CI, 0.5–1.8) and relative risk (0.95; 95% CI, 0.5–1.8) indicated that NSAIDs were not significantly associated with the risk of POMI. Mean duration of NSAID use was 3 days. Length of stay (98 versus 115 hours) was significantly reduced in the NSAID group. Conclusions Brief perioperative use of NSAIDs was not associated with increased risk for myocardial infarction after total hip and knee replacement; it may provide benefit in length of stay. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|