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Br J Surg. 2014 Oct;101(11):1413-23. doi: 10.1002/bjs.9614. Epub 2014 Aug 4.

Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery.

Collaborators (476)

Chapman SJ, Glasbey J, Kelly M, Khatri C, Nepogodiev D, Fitzgerald JE, Bhangu A, Bhangu A, Harrison EM, Adams R, Patel K, Khatri C, Retchless AR, Elsaddig M, Curtis AE, Nepogodiev D, Glasbey J, McMahon R, Mittapalli D, Ferguson LA, Gentry SV, Kong CY, Naqvi Z, Amin H, Chapman SJ, Kelly M, Chaudhry B, Burke J, Henderson I, Trecarten S, Clements JM, Drake TM, Wild JR, Venkatesh H, Butters N, Ahmeidat H, Goergen N, Adams R, Black D, Robertson K, Jama GM, McGuire SA, Ahl R, Suri TS, Kuo R, Fadhlillah M, Mills H, Mitchell R, Goodship J, Tan M, Barker T, Wright T, Mohamad W, Hanna N, Laing G, Warnock MW, Baird-Fraser PR, Logan T, Young FM, Fane De Salis AC, McHugh R, Drake TM, Hickson C, Paszkiewicz J, Anderson LB, Neeson D, Mohan M, Narang Y, Brophy T, Punj R, Majumdar S, Kauser S, Jong G, Palkhi E, Finch D, Curtis AE, Mitchell H, Carter N, Viyasar T, Sammut T, Cook N, Powell MM, Horne S, Allen JL, Marshall D, McIntyre C, S Koh DT, Shi J, Reid T, Armugam NP, Luck J, Fozard T, O'Callaghan J, Copley PC, Tilliriou V, Aiyer R, Yazdi A, Wiltshire A, Blower E, Jewitt C, Cheung LK, Fourali S, Rahimi Y, Velho R, Taylor C, Satterthwaite L, Eze NV, Johnston JP, McCain RS, Hess EC, Thumbadoo RP, Turner EJ, Wookey R, Morris R, Gasteratos K, Heywood E, Simpson SJ, Rai Z, Kazzazi D, Ducey J, Livesey MJ, Finan C, Staunton E, Haddad SD, Karanjia R, Bokobza I, Ahmed M, Howell J, Adams R, 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 JZ, Chong BF, Park JH, Kong CY, Mogan YP, Stevens S, Sekhon HK, McIntosh R, Ochiltree DW, Jamieson PD, Naumann DN, Bowley DM, Howell G, Clark T, Dear K, James L, Upchurch E, Wilson H, Hughes M, Retchless AR, Modayur SM, Naumann DN, Bowley DM, Datta U, Chen JH, Williams LJ, Selby J, Prabhudesai A, Mahomed K, Shah HA, Kong K, Chandramoorthy S, Marshall L, De Kauwe C, Rana R, Patel J, Pezas T, Ma J, Stohlner V, Kinsella MS, Gardiner SN, Smith RA, Glover M, Akinfala M, Lee JZ, Aggarwal V, Waters S, Atif M, Hill M, Ramasubramoni A, Jaffry Z, Sagoo H, Jeyakumar J, Kosasih S, Davis J, Stanley GH, Nijran J, Tang I, Mehta K, Fillery A, Watson NF, Shah D, Naidu S, Grewal TK, Singh P, Reissis D, Marusza C, Luck J, Pettit W, Timbrell S, Woods R, Phillips J, Vaughan R, Dean S, Gibby R, Jones TF, Rao R, Torrance HD, Thirumal V, McMahon RK, Yap D, Mittapalli D, Shaw A, Claireaux HA, Pang YL, Narramore R, Holmes C, Caldwell A, Daoub A, Bibby L, Hague AG, Sykes MC, Patel K, Morar P, Downes G, Shah S, Walimohamed S, Alsulaimi A, Biswas V, Gnaneswaran B, Davies N, Narwani V, Nepogodiev D, Hernon J, Jumbu A, Ilyas M, Johal G, Atia F, Williams A, Chan C, McAnelly S, Evans A, Chan KY, 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 VS, Kambasha C, Sait S, Tahir M, Trecarten S, Henderson I, Tharakan R, Voll J, Shiwani H, Al-Omran Y, Hawash A, McCaughan V, Shatkar V, Gohil K, Greenhalgh A, Higgins E, Moody T, Booth MB, Chan WH, Shanthakumaran S, Maple N, McNish D, Shahin B, Nicholas J, McDermid R, Narayan P, Brodie C, Hurrey S, Gentry SV, Panayi V, Turner B, Kopala K, Winfield SC, Mohamud A, Venkatesh A, Hosein S, Olimpio C, Gkiousias V, Kilgour JM, Cogbill E, Ramcham M, Carr G, Bannerman A, Grundy L, White S, Beamish A, Ferguson LA, Neo YN, Cragg AR, Harrison EM, Perkins A, Wynn-Hebden A, Khan T, Ali M, Battersby CL, Pinto RS, Poon SS, Patel M, Patel P, Shafi AM, Vedage D, Ghorbhanian S, Klimach S, Bradley J, de Sausmarez E, Hayward P, Naqib S, Flanigan C, Shuttleworth RH, Clements JM, McElvanna K, Shelton B, Westbrook N, Weir A, Webb P, Alam M, Bhanderi S, Roberts C, Al-Shakarchi J, Lu M, Harvey J, Chowdhury MU, McGow C, Antoniou I, Good DF, Gerasimova N, Eragat M, Pressler N, Santos CR, Arshad W, Patel HR, Kassim Y, Shah S, Jayaratne N, Perera A, Chandramoorthy L, Quan V, Ponweera A, Tadjkarimi J, Moyes L, Metcalfe C, Napier-Hemy T, Bull A, Elsaddig M, Jaffer Y, Mushtaq J, Warren M, Jarrar Z, Wickenden R, Kang M, Holohan G, Isbister T, Strachan E, Varma R, Chapman SJ, Simpson R, Rajasekar N, Panayiotou H, Walsh E, Thacoor A, Willson JM, Mustafa A, Barai I, Menon A, Soon WC, Thakrar C, Patel K, McCurdie S, Carr EC, Westwood KJ, Wardell H, Weinberg D, Craig AR, Khan FA, Mulla A, Dann P, Saleh M, Pignatelli IC, Igbagiri KV, Panagoulas EV, Tilston TW, Thayaparan AJ, Navaratnam J, Aryasomayajula S, Joji N, Screen R, Quinn C, Harrison R, Arnaout A, McCartan N, Allen W, Gabriel R, Hartelius CF, Makinde ML, Sivasubramaniam S, Spreadborough P, Lobo R, Surendran H, Couch L, Butters T, Beale K, Markiewicz O, Kennedy ED, Neely DM, Martin A, Al-Moasseb ZH, Ong KK, Letchumanan S, Lam WL, Yapp L, Skelly BL, Stallard S, Westhuizen PV, Rafferty AR, Lambert A, Tay YZ, Koshnow Z, Elamin O, Shah A, Kim E, English W, Farrell A, Sharma J, Rowan DC, Mullan B, Brown RJ, McCarter JA, Johnston D, Symonds C, Gatfield W, Messenger D, Knox JD, Jani P, Trinquet J, Naqvi ZB, Hussain K, Jaffer A, McAleer E, Joshi H, Cecil E, Lochrane A, Woolley T, Marriott P, Bolton W, Balian V, Scott AJ, Tan YH.

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 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 predominantly 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.

PMID:
25091299
DOI:
10.1002/bjs.9614
[Indexed for MEDLINE]

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