Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study

World J Surg. 2017 Jan;41(1):47-55. doi: 10.1007/s00268-016-3727-3.

Abstract

Background: Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery.

Methods: Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable. The primary outcome measure was the 30-day postoperative major complication rate, as defined by the Clavien-Dindo classification (Clavien-Dindo III-V). Propensity matching with multivariable logistic regression was used to produce odds ratios (OR) and 95 % confidence intervals.

Results: From 9264 patients, 23.9 % (n = 2212) received postoperative NSAIDs. The overall major complication rate was 11.5 % (n = 1067). Following propensity matching and adjustment, use of NSAIDs were not significantly associated with any increase in major complications (OR 0.90, 0.60-1.34, p = 0.560).

Conclusions: Early use of postoperative NSAIDs was not associated with an increase in major complications following gastrointestinal surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Digestive System Surgical Procedures* / adverse effects
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Prospective Studies

Substances

  • Anti-Inflammatory Agents, Non-Steroidal