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


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

DOI: 10.1007/s00268-016-3727-3

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@article{Abbas2016SafetyON, title={Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study}, author={Zaigham Abbas and Sunitha Abburu and Momin Ghaffar and Maha Abdelhadi and H. R. Abdikadir and Anne Maathai Abdulmajid and Hanene Abid and Abdelfatteh Abid and Nadia Abuhussein and Mehtap Haktanır Abul and Frank Acquaah and Matthew Acres and Rohan Adams and Adekunle Azeez Adebayo and I. Adeleja and H. Adjei and Zahid Ahmed Afzal and Vikas Agarwal and Nicole Ahern and Khurshid Ahmad and Sayeed Ahmad and M. Ahmed and H. Ahmed and N. Ahmed and Sheraz Ahmed and Fahim Ahmed and Jeong Suk Ahn and G. E. Aidoo-Micah and Laxmi Aildasani and J. M. Aithie and S. Akhtar and Sadiq Shahbaz Ali and Ali Adil Ali and Biengoua Ali and Mohammad Hyder Ali and Samaher Hussein Ali and Moein Alizadeh and Corinne Allan and John Lee Y Allen and R. Allot and Ahmed M. Al-mousawi and O. Al-Obaedi and A. Al-Robeye and Adaugo Amajuoyi and Himal Amin and Om Amin and Alexander Amphlett and Cholan Anandarajah and Lynne B Anderson and Shane M. Anderson and Alan Js Ang and Sophia Angelov and Adikesavalu Anilkumar and N. Anim-Addo and Naima Ansari and Ioulia Antoniou and Caroline Archer and Tara Arif and C. A. Asbjoernsen and Umna Ashfaq and Lucy Ashken and Shoaib Ashraf and andLesley J. Ashton and Jason Ashwood and Alec Aslanyan and Aldi Asmadi and Shiekh Assadullah and Atefe Atayi and B. A. Atraszkiewicz and Mohamed Attalla and L. Austreng and E. Auyoung and Philippe Avery and T. Axelson and Hassan Aziz and Nazrina Aziz and Allison N Baker and Z. R. Bakewell and Amani Bakhsh and Sam Balaji and Vruyr Balian and F. A. Bamgbose and Ishani Barai and Joaqu{\'i}n Barn{\'e}s and Thomas Barrow and Andy Barthorpe and Jake Bartlett and Richard D Bartlett and Emily C Barton and Nabila Bassam and Jonathan Bassett and S. Bassiony and Michael F Bath and A. Batho and Erez Batt and H. Z. 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Buakuma and Alistair M Buchan and Rory T Buckle and Ana Bucko and F A Bulley and L. M. Bullman and Nicola Bullock and Arnaud Burgess and Joshua Burke and Danielle L Burke and Eleanor J. Burke and Laura Burney and R. Callan and Judith L. Campbell and N. Canning and Emma Canning and Yong Cao and Antonia Elizabeth Cardwell and LK Carr and Robert W. Carr and Alan F Carroll and Dylan Carter and L. Carthew and MINDI CHAMBERLAIN and Nadia Chan and C. Chan and Neha Chandan and Stephanie Chapman and Max Charalambos and Giorgos Charalambous and Amynah Charania and V. Charavanamuttu and Mamta Chaudhary and Fatima Imam Chaudhry and Waleed W Chaudhry and Haroon Cheema and J. Chen and Xiao Chen and M. Chen and Kai-Lun Cheng and Jordan Vassileff Chervenkoff and Lindsay Cheskes and FMF Cheung and Luen Shaun Chew and Annikar Chhabra and Cynthia Chhina and C. P. Chilima and Geetha R. Chillarge and N. J. Chilvers and Hyouk-Jun Chin and R R Chin and Elizabeth Chisholm and Abhishek Rajeev Chitnis and Shih Min Chiu and B F Chong and June Chong and Kyoung-Ja Choo and D. Chrastek and Ee Yin Chua and Anne Chung and Henry A. Claireaux and Ingrid J Clark and Anthony R. Clarke and Jason J Cleere and Keiran David Clement and Kevin Clesham and Alysha Coates and A . Cody and Nuala Cody and Daniel Coffey and Chris Coffey and Joan Coffin and Stuart J. Cole and Hailey K Collier and Anton Collins and Devin Collins and Shannon Collinson and Greg E Cooper and DJ Cooper and Hannah Charlotte Copley and Phillip Correia Copley and Elizabeth M Cornish and Ann Cotton and Rose-Marie Coulson and SE Cox and Adam R Craig and Ewan Craig and Anna Craig-McQuaide and Joan Crewdson and Amanda Croall and Laurie Crozier and Connie Cullen and Seamus Cullen and G. Culleton and Elspeth Cumber and Suzanne Cumming and O. J. Cundy and Passos Cunha and Adri{\'a}n Curran and Georgina F. Cuthbert and W. Cymes and Ahmed Daoub and Stacy Darr and M. Das and Usha Datta and Niel Davies and Jonathan I. Davies and James E. Davies and KL Davies and M. Davis-Hall and Rajni Dawar and P. Dawson and Gabrielle Bernier and Ciara E Deall and Ravnik Dean and Shelley Dean and William Dean and Keith B G Dear and Gavin Deas and R K Debenham and Praveena Deekonda and Anzelle Delport and A. M. Demetri and Y. F. Dennis and RJ Dennis and Laura F Derbyshire and Y. Devabalan and Edward Devlin and Charlotte Dewdney and A-R A Dhanji and Madhu S. Dhar and Amrita J Dhutia and Charles J M Diaper and John S. Dickson and Wenbing Din and Shiva Dindyal and Lori Dinsmore and Linda Doan and Jessica Dobson and Tanuja Dogra and Cornelius Doherty and MJ Dolaghan and Katelyn S Dolbec and Christina Dorman and Thomas M. Drake and C. Drislane and Poonam Dube and Austin Duffy and Katie Duke and Joseph W Duncumb and Charlotte E Dunn and Alexandra Durr and Behram K Durrani and Suniti Dutt and Ansil Dyal and Kaitlyn Dynes and Marie Alexandra Edison and Francis C. Edozie and Richard John Egan and C J Egerton and Vadamalai Elangovan and D. Elf and M. Elkawafi and Laine E Elliott and M. Elseedawy and J C Empey and WA English and Jeffrey Entwisle and K. Eparh and Mazin Eragat and John Eraifej and Lluis Esteve and Jackie D. Farmer and T. Fautz and Neide F{\'a}vero and Aisling S Fawaz and P. Fergurson and Jesse Fern and J. J. Filby and Teodora Filipescu and Jonathan Fitzgerald and Dr C. C. Fitzpatrick and Richard J Fleck and Lydia Fletcher and Jay Fong and P. R. Forrest and Biagio Forte and Norman L. Foster and C. T. Francescon and Arthur L. Frank and Tze M Fung and Joshue Gabriel and Shirley Gaffney and Elisabeth Galloway and Kali Gandhi and Nalini Gardiner and Earl Gardner and Horace B. Gardner and W. A. Gatfield and L. Gauntlett and Susan Gentry and Danielle George and John M . Geraghty and Atif Ghaffar and Howard Gilbert and Jodie E. Giles and Preetjote Gill and Catherine Gill and Christine Girling and James C Glasbey and Tyrone Glover and Bok-Lan Goh and Rebecca W. Goh and Kamlesh Gohil and Shyam Ajay Gokani and Darren Marc Gold and David M Golding and Tessa A Goldsmith and Robyn Goodier and Hrishikesh J. Goradia and Pishoy Gouda and C. Gouldthrope and S. Govinden and Carole J Graham and Robert J. Gratton and Laurel Gray and Andrew D. Greenhalgh and Robert J. H. Greig and Emma J. Griffin and C. M. Grossart and Linda Grundy and Jagdeep Gulati and Buket Gundogan and V. K. Gupta and Adam M Gwozdz and ZAHID HUSSAIN SIDDIQUI and Angela C. Hague and Maytham Hameed and Margret Hanrahan and Hammad Haq and Gurkaran Singh and Jim W. Hardie and Fiona Harding and Mary R. Hardy and Priscilla Harries and Reuben T. Harris and Lydsay N. Harris and Ewan M Harrison and Pat Harrison and Jeanne Hartley and Suzanne Hartley and J. Harvey and Soueid Hassan and Marium Hayat and Umer Hayat and Jasmine Hayes and An-Bing He and Leonard D. Healy and Edwin Heathcote and R. S. Heer and R. Heminway and Isabel Henderson and Luana Henderson and Calen B. Henderson and Helen Mary Heneghan and Anne Henson and G. Heppenstall-Harris and Jerry M Herron and Joseph Heskin and Eric J. Hester and Christopher M. Hewitt and E. G. Heywood and Angus Hibberd and Stephen Hickling and Anna Higgins and Littlest Higgs and Arnold S K Hill and Ian H Fisher and Shashivadan Hirani and F. Hirst and NEIL HITCHEN and W-M Ho and Sunita Pullela Ho and Katie Hoban and Rex Holliday and Cheryl Holloway and Clive Holmes and Maura Holmes and Peter Holton and H. Holyoak and Lesley Horne and Cindy Horst and David Horth and Travis J C Hoskins and Lara Howells and Li Hu and H. C. Huang and Sarah Hudson-Phillips and Flavia Hughes and Beverly Hughes and Rose K. Hughes and K. Hulley and Guang-Uei Hung and P. C. Hurst and S. B. Husnoo and Nik Hussain and Omar Khadeer Hussain and Ibtesam Ibrahim and Abdelhameed Ibrahim and Rene Ingham and Emma E. Ingram and S. Iqbal and Atif Iqbal and Adil Isaac and Harry Jackson and Stephen H D Jackson and Lyan Jacob and Daniyal J Jafree and Arun Jaitley and P. Jalota and Nida Jamal and N. Jathanna and Ali S.M. Jawad and Nimeshi Jayakody and Sarah Jenkin and Caitlin J. Jenvey and Patrick D Jewell and H. I. Jhala and Alka Jindal and Atholl Johnston and James O. Johnston and Marianne Johnstone and Heather Jordan and Kaustuv R Joshi and Dattakiran Joshi and Helena Joyce and Campbell D Joyner and C. L. Jubainville and Philip Jull and Meeriam Kadicheeni and Anita Kahar and Nitish Kalra and S. Kanabar and Timothy P C Kane and Monil Karia and Priya Karia and R. B. Karsan and Poongkodi Karunakaran and Anuj Kaushal}, journal={World Journal of Surgery}, year={2016}, volume={41}, pages={47-55} }