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 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.
| Original language | English |
|---|---|
| Pages (from-to) | 1413-1423 |
| Number of pages | 11 |
| Journal | British Journal of Surgery |
| Volume | 101 |
| Issue number | 11 |
| Early online date | 4 Aug 2014 |
| DOIs | |
| Publication status | Published - Oct 2014 |
Keywords
- anastomotic leakage
- society recommendations
- colorectal surgery
- perioperative care
- enhanced recovery
- colonic surgery
- risk
- complications
- guidelines
- inhibitor
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Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery. / Chapman, S. J.; Collaborative, STARSurg; Glasbey, J. et al.
In: British Journal of Surgery, Vol. 101, No. 11, 10.2014, p. 1413-1423.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery
AU - Chapman, S. J.
AU - Collaborative, STARSurg
AU - Glasbey, J.
AU - Kelly, M.
AU - Khatri, C.
AU - Nepogodiev, D.
AU - Fitzgerald, J. E. F.
AU - Bhangu, A.
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AU - Khatri, C.
AU - Retchless, A. R.
AU - Elsaddig, M.
AU - Curtis, A. E.
AU - Nepogodiev, D.
AU - Glasbey, J.
AU - McMahon, R.
AU - Mittapalli, D.
AU - Ferguson, L. A.
AU - Gentry, S. V.
AU - Kong, C. Y. N.
AU - Naqvi, Z.
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AU - Chapman, S. J.
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N1 - The Committee thanks all the consultant surgeons who supported and advised the STARSurg teams working in their departments. The Royal College of Surgeons of England provided meeting facilities for a collaborator training day and the Association of Surgeons in Training (http://www.asit.org) supported this meeting with an ASiT Regional Event Grant.
PY - 2014/10
Y1 - 2014/10
N2 - 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.
AB - 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.
KW - anastomotic leakage
KW - society recommendations
KW - colorectal surgery
KW - perioperative care
KW - enhanced recovery
KW - colonic surgery
KW - risk
KW - complications
KW - guidelines
KW - inhibitor
U2 - 10.1002/bjs.9614
DO - 10.1002/bjs.9614
M3 - Article
VL - 101
SP - 1413
EP - 1423
JO - British Journal of Surgery
JF - British Journal of Surgery
SN - 0007-1323
IS - 11
ER -