학술논문
Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery
Document Type
Report
Author
Chapman, S. J.; Glasbey, J.; Kelly, M.; Khatri, C.; Nepogodiev, D.; Fitzgerald, J. E. F.; Bhangu, A.; Harrison, E. M.; Adams, R.; Patel, K.; Retchless, A. R.; Elsaddig, M.; Curtis, A. E.; McMahon, R.; Mittapalli, D.; Ferguson, L. A.; Gentry, S. V.; Kong, C. Y. N.; Naqvi, Z.; Amin, H.; Chaudhry, B.; Burke, J.; Henderson, I.; Trecarten, S.; Clements, J. M.; Drake, T. M.; Wild, J. R. L.; Venkatesh, H.; Butters, N.; Ahmeidat, H.; Goergen, N.; Black, D.; Robertson, K.; Jama, G. M.; McGuire, S. A.; Ahl, R.; Suri, T. S.; Kuo, R.; Fadhlillah, M.; Mills, H.; Mitchell, R.; Goodship, J.; Tan, M.; Barker, T.; Wright, T.; Mohamad, W.; Hanna, N.; Laing, G.; Warnock, M. W. C.; Baird-Fraser, P. R.; Logan, T.; Young, F. M.; Fane De Salis, A. C.; McHugh, R.; Hickson, C.; Paszkiewicz, J.; Anderson, L. B.; Neeson, D.; Mohan, M.; Narang, Y.; Brophy, T.; Punj, R.; Majumdar, S.; Kauser, S.; Jong, G.; Palkhi, E.; Finch, D.; Mitchell, H.; Carter, N.; Viyasar, T.; Sammut, T.; Cook, N.; Powell, M. M.; Horne, S.; Allen, J. L. Y.; Marshall, D.; McIntyre, C.; S Koh, D. T.; Shi, J.; Reid, T.; Armugam, N. P.; Luck, J.; Fozard, T.; O'Callaghan, J.; Copley, P. C.; Tilliriou, V.; Aiyer, R.; Yazdi, A.; Wiltshire, A.; Blower, E.; Jewitt, C.; Cheung, L. K.; Fourali, S.; Rahimi, Y.; Velho, R.; Taylor, C.; Satterthwaite, L.; Eze, N. V.; Johnston, J. P. M.; McCain, R. S.; Hess, E. C. F.; Thumbadoo, R. P.; Turner, E. J. H.; Wookey, R.; Morris, R.; Gasteratos, K.; Heywood, E.; Simpson, S. J.; Rai, Z.; Kazzazi, D.; Ducey, J.; Livesey, M. J.; Finan, C.; Staunton, E.; Haddad, S. D.; Karanjia, R.; Bokobza, I.; Ahmed, M.; Howell, J.; Grainger, C.; Woo, A.; McDowall, M.; Bulley, F.; Keating, R.; Tan, B.; Sng, S.; Brown, C.; Aidoo-Micah, G.; Champsi, A.; Ellis, R.; Darwazeh, S.; Polson, R.; Chan, J. Z.; Chong, B. F. H. K.; Park, J. H.; Kong, C. Y.; Mogan, Y. P.; Stevens, S.; Sekhon, H. K.; McIntosh, R.; Ochiltree, D. W.; Jamieson, P. D.; Naumann, D. N.; Bowley, D. M.; Howell, G.; Clark, T.; Dear, K.; James, L.; Upchurch, E.; Wilson, H.; Hughes, M.; Modayur, S. M.; Datta, U.; Chen, J. H. C.; Williams, L. J. L.; Selby, J.; Prabhudesai, A.; Mahomed, K.; Shah, H. A.; Kong, K.; Chandramoorthy, S.; Marshall, L.; De Kauwe, C.; Rana, R.; Patel, J.; Pezas, T.; Ma, J.; Stohlner, V.; Kinsella, M. S.; Gardiner, S. N.; Smith, R. A.; Glover, M.; Akinfala, M.; Lee, J. Z. C.; Aggarwal, V.; Waters, S.; Atif, M.; Hill, M.; Ramasubramoni, A.; Jaffry, Z.; Sagoo, H.; Jeyakumar, J.; Kosasih, S.; Davis, J.; Stanley, G. H. M.; Nijran, J.; Tang, I.; Mehta, K.; Fillery, A.; Watson, N. F.; Shah, D.; Naidu, S.; Grewal, T. K.; Singh, P.; Reissis, D.; Marusza, C.; Pettit, W.; Timbrell, S.; Woods, R.; Phillips, J.; Vaughan, R.; Dean, S.; Gibby, R.; Jones, T. F.; Rao, R.; Torrance, H. D. T.; Thirumal, V.; McMahon, R. K.; Yap, D.; Shaw, A.; Claireaux, H. A.; Pang, Y. L.; Narramore, R.; Holmes, C.; Caldwell, A.; Daoub, A.; Bibby, L.; Hague, A.G.; Sykes, M. C.; Morar, P.; Downes, G.; Shah, S.; Walimohamed, S.; Alsulaimi, A.; Biswas, V.; Gnaneswaran, B.; Davies, N.; Narwani, V.; Hernon, J.; Jumbu, A.; Ilyas, M.; Johal, G.; Atia, F.; Williams, A.; Chan, C.; McAnelly, S.; Evans, A.; Chan, K. Y.; Flegg, K.; Carter, S.; Coley, J.; Khaw, R.; Jayakody, N.; Jones, B.; Fawcett, N.; Ghali, C.; Jalundhwala, K.; Ariyaratnam, P.; Colville, H.; Walls, M.; Lindsay, J.; Keane, M.; Ban, V. S.; Kambasha, C.; Sait, S.; Tahir, M.; Tharakan, R.; Voll, J.; Shiwani, H.; Al-Omran, Y.; Hawash, A.; McCaughan, V.; Shatkar, V.; Gohil, K.; Greenhalgh, A.; Higgins, E.; Moody, T.; Booth, M. B.; Chan, W. H.; Shanthakumaran, S.; Maple, N.; McNish, D.; Shahin, B.; Nicholas, J.; McDermid, R.; Narayan, P.; Brodie, C.; Hurrey, S.; Panayi, V.; Turner, B.; Kopala, K.; Winfield, S. Clayton A.; Mohamud, A.; Venkatesh, A.; Hosein, S.; Olimpio, C.; Gkiousias, V.; Kilgour, J. M.; Cogbill, E.; Ramcham, M.; Carr, G.; Bannerman, A.; Grundy, L.; White, S.; Beamish, A.; Neo, Y. N.; Cragg, A. R.; Perkins, A.; Wynn-Hebden, A.; Khan, T.; Ali, M.; Battersby, C. L. F.; Pinto, R. S.; Poon, S. S.; Patel, M.; Patel, P.; Shafi, A. M. A.; Vedage, D.; Ghorbhanian, S.; Klimach, S.; Bradley, J.; de Sausmarez, E.; Hayward, P.; Naqib, S.; Flanigan, C.; Shuttleworth, R. H. A.; McElvanna, K.; Shelton, B.; Westbrook, N.; Weir, A.; Webb, P.; Alam, M.; Bhanderi, S.; Roberts, C.; Al-Shakarchi, J.; Lu, M.; Harvey, J.; Chowdhury, M. U.; McGow, C.; Antoniou, I.; Good, D. F.; Gerasimova, N.; Eragat, M.; Pressler, N.; Santos, C. R. D.; Arshad, W.; Patel, H. R.; Kassim, Y.; Jayaratne, N.; Perera, A.; Chandramoorthy, L.; Quan, V.; Ponweera, A.; Tadjkarimi, J.; Moyes, L.; Metcalfe, C.; Napier-Hemy, T; Bull, A.; Jaffer, Y.; Mushtaq, J.; Warren, M.; Jarrar, Z.; Wickenden, R.; Kang, M.; Holohan, G.; Isbister, T.; Strachan, E.; Varma, R.; Simpson, R.; Rajasekar, N.; Panayiotou, H.; Walsh, E.; Thacoor, A.; Willson, J. M. H.; Mustafa, A.; Barai, I.; Menon, A.; Soon, W. C.; Thakrar, C.; McCurdie, S.; Carr, E. C. F.; Westwood, K. J.; Wardell, H.; Weinberg, D.; Craig, A. R. J.; Khan, F. A. S.; Mulla, A.; Dann, P.; Saleh, M.; Pignatelli, I. C.; Igbagiri, K. V.; Panagoulas, E. V.; Tilston, T. W.; Thayaparan, A. J.; Navaratnam, J.; Aryasomayajula, S.; Joji, N.; Screen, R.; Quinn, C.; Harrison, R.; Arnaout, A.; McCartan, N.; Allen, W.; Gabriel, R.; Hartelius, C. F.; Makinde, M. L.; Sivasubramaniam, S.; Spreadborough, P.; Lobo, R.; Surendran, H.; Couch, L.; Butters, T.; Beale, K.; Markiewicz, O.; Kennedy, E. D.; Neely, D. M.; Martin, A.; Al-Moasseb, Z. H.; Ong, K. K.; Letchumanan, S.; Lam, W. L.; Yapp, L.; Skelly, B. L.; Stallard, S.; Westhuizen, P. V. D.; Rafferty, A. R.; Lambert, A.; Tay, Y. Z.; Koshnow, Z.; Elamin, O.; Shah, A.; Kim, E.; English, W.; Farrell, A.; Sharma, J.; Rowan, D. Chudek. K.; Mullan, B.; Brown, R. J.; McCarter, J. A.; Johnston, D.; Symonds, C.; Gatfield, W.; Messenger, D.; Knox, J. D.; Jani, P.; Trinquet, J.; Naqvi, Z. B.; Hussain, K.; Jaffer, A.; McAleer, E.; Joshi, H.; Cecil, E.; Lochrane, A.; Woolley, T.; Marriott, P.; Bolton, W.; Balian, V.; Scott, A. J.; Tan, Y. H.
Source
British Journal of Surgery. Oct 2014, Vol. 101 Issue 11, p1413, 11 p.
Subject
Language
English
ISSN
0007-1323
Abstract
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 2days 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 (16ae1 per cent) of 1503 patients. Complications occurred in 981 patients (65ae3 per cent), which were major in 257 (17ae1 per cent) and minor (Dindo-Clavien grade I-II) in 724 (48ae2 per cent). Propensity score matching created well balanced groups. Treatment with NSAIDs was associated with a reduction in overall complications (OR 0ae72, 95 per cent confidence interval 0ae52 to 0ae99; P=0ae041). This effect predominately comprised a reduction in minor complications with high-dose NSAIDs (OR 0ae57, 0ae39 to 0ae89; P=0ae009). Conclusion Early use of NSAIDs is associated with a reduction in postoperative adverse events following major gastrointestinal surgery. CAPTION(S): Table S1 Dindo-Clavien classification of surgical complications (Word document) Table S2 Definition of high- and low-dose non-steroidal anti-inflammatory drug use (Word document) Table S3 Revised Cardiac Risk Index (Word document)