Use of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with an increased risk of anastomotic leak at the surgical junction in patients undergoing non-elective colorectal procedures, according to a study published online by JAMA Surgery.
Timo W. Hakkarainen, MD, University of Washington Medical Center, Seattle, Washington, and colleagues examined postoperative NSAID use and anastomotic complications among 13,082 patients undergoing bariatric or colorectal surgery at 47 hospitals in Washington from 2006 through 2010. The researchers used data from the Surgical Care and Outcomes Assessment Program.
Of the patients in the study, 3,158 (24.1%) received NSAIDs postoperatively. Patients who received NSAIDs were younger, had lower levels of co-existing illnesses, a lower cardiac risk index, and had elective procedures more frequently than those patients who did not receive NSAIDs.
The overall 90-day rate of anastomotic leaks was 4.3% for all patients (4.8% in the NSAID group and 4.2% in the non-NSAID group). NSAIDs were associated with a 24% increased risk for anastomotic leak after risk adjustment and this association was isolated to non-elective colorectal surgery, where the leak rate was 12.3% in the NSAID group and 8.3% in the non-NSAID group.
There was no effect for patients undergoing elective colorectal or bariatric surgery.
“The results of this large state-wide cohort study show that, among patients undergoing non-elective colorectal resection, postoperative NSAID administration is associated with a significantly increased risk for anastomotic complications,” the authors wrote. “Given that other analgesic regimens are effective and well tolerated, these data may be enough for some surgeons to alter practice patterns.”
SOURCE: JAMA Surgery</p>
