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

著者: STARSurg Collaborative, Stephen J. Chapman, James Glasbey, Michael E. Kelly, Chetan Khatri, D Nepogodiev, J.E.F. Fitzgerald, Aneel Bhangu, Aneel Bhangu, Ewen M. Harrison, R Adams, Kirtan Patel, Chetan Khatri, A R Retchless, Malaz Elsaddig, A E Curtis, D Nepogodiev, James Glasbey, R McMahon, Devender Mittapalli, Lucie Ferguson, S V Gentry, C Y N Kong, Zoon Naqvi, H Amin, S J Chapman, Michael E. Kelly, Burhan Chaudhry, Josh Burke, Ian Henderson, S Trecarten, J M Clements, T M Drake, Jonathan Wild, HA Venkatesh, Nelson Butters, H Ahmeidat, N Goergen, R Adams, D.A.K. Black, K Robertson, Guled M. Jama, Shirley McGuire, Rebecka Ahl, T Suri, Rachel Kuo, Fiqry Fadhlillah, Harriet L. Mills, Rachel L.C. Mitchell, Judith Goodship, Mark Tan, T. Barker, Timothy Wright, Wan Mohamad Zahiruddin Wan Mohamad, Nader Hanna, Grant Laing, M W C Warnock, Patrick Baird-Fraser, T. Logan, Fiona Young, A Salis, R McHugh, T M Drake, Craig Hickson, Justyna Paszkiewicz, Lorraine Anderson, Declan Neeson, Midhun Mohan, Yajur Narang, T Brophy, R. Punj, Sumit R. Majumdar, Samina Kauser, Greta de Jong, E Palkhi, David Finch, A E Curtis, Harriet Mitchell, N Carter, Thevarajah Viyasar, T Sammut, Nicole Cook, Mackenzie Powell, Sylvia J. Horne, J. L. Allen, Dominic C. Marshall, Charlotte McIntyre, Dong-Hee Koh, Jing Shi, T. Reid, Nindra Armugam, Joshua Luck, Thomas Fozard, John M. O’Callaghan, P C Copley, V Tilliriou, Ravi Aiyer, A Yazdi, Alison Wiltshire, Emma Blower, Chelcie Jewitt, Lydia Cheung, Samih Fourali, Yashar Rahimi, Rochelle Velho, Claire Taylor, L. Satterthwaite, Nneka Eze, J P M Johnston, Scott McCain, Elmer Hess, Ruben Thumbadoo, Eleanor Jane Turner, Rachel Wookey, ROGER S. MORRIS, Konstantinos Gasteratos, Emily G. Heywood, Stephen J. Simpson, Z Rai, Diana Kazzazi, Jonathan Ducey, M J Livesey, Chris Finan, Esther Staunton, S.D. Haddad, Rustum Karanjia, I Bokobza, M Ahmed, Jane M. Howell, Rachel Adams, Charlotte Grainger, Anna Woo, M. McDowall, F. A. Bulley, Ryan W. Keating, Bin Tan, S. Sng, C. Brown, G Aidoo-Micah, A Champsi, Ronald J. Ellis, S Darwazeh, R Polson, Jessica Z. Chan, Benjamin F. Chong, James H. Park, Chia Yew Kong, Yogendra Praveen Mogan, Simon Stevens, Harveen K. Sekhon, R. McIntosh, D W Ochiltree, Philip Jamieson, David N Naumann, Douglas M. Bowley, Gina M. Howell, Tanya Clark, Keith L. Dear, Laura James, Emma Upchurch, Holly Wilson, Michael Hughes, A R Retchless, S M Modayur, David N Naumann, Douglas M. Bowley, Uttaran Datta, J H C Chen, Luke Williams, James W. Selby, A Prabhudesai, Kassam Mahomed, Haider Shah, Kyoung Ae Kong, S Chandramoorthy, Lisa Marshall, C De Kauwe, Randeep Rana, Jayna Patel, Theodore Pezas, Jennifer Ma, V Stohlner, Mike Kinsella, Siobhan Gardiner, Rachel Smith, Michael Glover, M. Akinfala, Jeyoung Lee, Vaibhav Aggarwal, Samuel T. Waters, Muhammad Atif, Michael D. Hill, A Ramasubramoni, Zahra Jaffry, Harkiran Sagoo, Julia Edwin Jeyakumar, S Kosasih, James S. Davis, Guy Stanley, J Nijran, I Tang, Krisha Mehta, A. Fillery, Nicholas FS Watson, Dipal Shah, Sailendra Naidu, T Grewal, Pritam Singh, Dimitris Reissis, Chris Marusza, Joshua Luck, William Pettit, S Timbrell, Rodney Woods, Jim Phillips, Rachel Vaughan, S Dean, Robert G. Gibby, Timothy F. Jones, R Rao, Hew D.T. Torrance, V Thirumal, R McMahon, Desmond Y. H. Yap, Devender Mittapalli, Alexander R. Shaw, H A Claireaux, Yonghui Pang, Ruth Narramore, C Holmes, Aaron R. Caldwell, Ahmed Daoub, Louis Bibby, Adam Hague, M. Sykes, K Patel, Pritesh Morar, Graeme M Downes, S Shah, S Walimohamed, Ali Alsulaimi, Viveka Biswas, Bruno Gnaneswaran, N Davies, Vishal Narwani, Dmitri Nepogodiev, James Hernon, A Jumbu, Mohammad Ilyas, Gurpreet Johal, F Atia, Adam Williams, Carlos H.F. Chan, Sarah-Louise McAnelly, Adam S. Evans, Kin Yik Chan, Kaitlyn Flegg, S Carter, Jenny Coley, Rachel A Khaw, Nimeshi Jayakody, Bryony A. Jones, Nancy Fawcett, C Ghali, K Jalundhwala, Priyadharshanan Ariyaratnam, Heidi Colville, Martin Walls, James O. Lindsay, Maccon Keane, Vin Shen Ban, C Kambasha, S Sait, Muhammad Rizwan Tahir, S Trecarten, Ian Henderson, Ravi Tharakan, Jessika Voll, Hunain Shiwani, Yousef A. Alomran, Ahmed A. Hawash, Vincent McCaughan, Veeranna Shatkar, Kajal Gohil, Andrew D. Greenhalgh, E. Higgins, Terry W. Moody, M B Booth, Weng Hoong Chan, S Shanthakumaran, Natalie Maple, David Mcnish, B Shahin, J.R. Nicholas, Robert C. McDermid, P Narayan, Caroline Brodie, S Hurrey, S V Gentry, Vasilis Panayi, Benjamin Turner, K Kopala, S Clayton A Winfield, A Mohamud, Arjun K. Venkatesh, S Hosein, Catarina Olimpio, Vasileios Gkiousias, James M. Kilgour, Elizabeth Cogbill, M Ramcham, Gordon Carr, A Bannerman, Lisa Grundy, Sarah White, Andrew J. Beamish, Lucie Ferguson, Yan Ning Neo, Amber Cragg, Ewen M. Harrison, Anthony V. Perkins, A Wynn-Hebden, T Khan, M Ali, Christopher Battersby, R S Pinto, Steven S.S. Poon, Mulchand S. Patel, Prashant Patel, Ahmed Mohamed Abdel Shafì, Dave Vedage, S Ghorbhanian, Stefan Klimach, J. A. Bradley, E de Sausmarez, Philip Hayward, S. Naqib, Cynthia Flanigan, RD Shuttleworth, J M Clements, K McElvanna, B Shelton, Nancy Ann Westbrook, Alva B. Weir, Penelope M. Webb, MD Jobayer Alam, Shivam Bhanderi, Charlotte Roberts, J Al-Shakarchi, Ming Lu, J. Harvey, M U Chowdhury, C McGow, Ioannis Antoniou, D F Good, Н. С. Герасимова, Mazin Eragat, Nickki Pressler, Catarina Rolo Santos, Waleed Arshad, H R Patel, Yaser Yahya Kassim, S Shah, Nirmitha Jayaratne, A.H. Perera, L Chandramoorthy, Vincent Quan, Arachchige Ponweera, James Tadjkarimi, Lisa H Moyes, Christopher Metcalfe, Timothy P Napier-Hemy, Ann Bull, Malaz Elsaddig, Yasmin A. Jaffer, Jameel Mushtaq, M. Warren, Zakariya Jarrar, R Wickenden, Min Kyu Kang, G Holohan, T Isbister, E Strachan, Rick Varma, S J Chapman, R Simpson, N. Rajasekar, Hannah Panayiotou, E. Walsh, Amitabh Thacoor, J M H Willson, A Mustafa, Ishani Barai, A Menon, Wai Cheong Soon, Chiraag Thakrar, K Patel, S McCurdie, EdwardA. Carr, Karen J. Westwood, Hanna Wardell, David V. Weinberg, Ashley Craig, F A S Khan, Abdulrahim Mulla, Peter Dann, Mohannad Abou Saleh, Ilaria Pignatelli, Kueni Igbagiri, Eleni Panagoulas, Thomas W Tilston, Anthony Thayaparan, Jeya Navaratnam, Sirish Aryasomayajula, Nikita Joji, R Screen, Charles T. Quinn, Ewen M. Harrison, A Arnaout, Neil McCartan, William A. Allen, R Gabriel, Carl Hartelius, Misty Makinde, S. Sivasubramaniam, Philip Spreadborough, Richard Roberto Lobo, Haripriya Parapparambil Surendran, Liam S. Couch, Terry D. Butters, Kylie Beale, Ola Markiewicz, Ewan D. Kennedy, D M Neely, A Martin, Z. Al-Moasseb, Kenneth Ong, SV Letchumanan, Winnie Lam, Liam Z. Yapp, Michael E. Kelly, Sheila Stallard, P V D Westhuizen, AR Rafferty, Andrea Lambert, Yao Zong Tay, Z Koshnow, O Elamin, Apar Shah, E Kim, William English, Andrew Farrell, Jai Bhagwan Sharma, D Chudek K Rowan, Brendan Mullan, R. J. Brown, J. A. McCarter, Dorothy Johnston, C. P. Symonds, W. A. Gatfield, David Messenger, J. D. E. Knox, Pankaj Jani, J Trinquet, Zehra Naqvi, K Hussain, Amir K. Jaffer, Eilish McAleer, Hema Joshi, Elizabeth Cecil, Annabel Lochrane, Thomas W. Woolley, Philip J. Marriott, William Bolton, V Balian, Alasdair Scott, Yanhong Tan - British journal of surgery 2014 被引用: 93

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.