Bleeding risk from nonsteroidal anti‐inflammatory drugs after functional endoscopic sinus surgery: Analysis of the TriNetX database
| Title: | Bleeding risk from nonsteroidal anti‐inflammatory drugs after functional endoscopic sinus surgery: Analysis of the TriNetX database |
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| Authors: | Mandy K. Salmon, Jacob G. Eide, Rijul S. Kshirsagar, James N. Palmer, Nithin D. Adappa, Michael A. Kohanski |
| Source: | World Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 10, Iss 4, Pp 303-308 (2024) |
| Publisher Information: | Wiley, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Otorhinolaryngology LCC:Surgery |
| Subject Terms: | drug therapy, epidemiology, surgery, Otorhinolaryngology, RF1-547, Surgery, RD1-811 |
| More Details: | Abstract Objectives Postoperative pain medications and aspirin before undergoing functional endoscopic sinus surgery (FESS) are managed carefully due to concern for bleeding. Little is known regarding the increase in the risk of bleeding for patients unable to stop aspirin as trials are limited in this area. We compared outcomes for patients undergoing FESS who were managed postoperatively with nonsteroidal anti‐inflammatory drugs (NSAIDs) versus opioids. We also determined the epistaxis rate for patients on aspirin at the time of surgery compared to those who were not on aspirin. Data Source Retrospective analysis of patients undergoing FESS using the TriNetX database. Methods Patients were propensity‐matched, and the odds of bleeding complications between the patients prescribed postoperative NSAIDs were compared to those prescribed opioids. We also compared postoperative odds of bleeding in patients unable to halt aspirin use at the time of surgery to those who were not on aspirin before surgery. Results A total of 51,361 patients received opioids after FESS compared to 1923 patients who received NSAIDs. After propensity matching, 1918 patients were in each group and odds of epistaxis were similar between the NSAID group and the opioid group (odds ratio [OR]: 1.32, 95% confidence interval (CI): 0.90–1.94); 7.67% of the NSAID group required rescue opioids. Patients on aspirin who were unable to hold aspirin at surgery showed bleeding rates of 14.67% compared to 9.00% in propensity‐matched controls who were not on aspirin (OR: 1.74, 95%CI: 1.20–2.51). Conclusions NSAID use appears to be a safe alternative to opioids for patients without pre‐existing risk factors for bleeding. Patients who remained on aspirin in the week before FESS had an increased risk of postoperative epistaxis. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2589-1081 2095-8811 |
| Relation: | https://doaj.org/toc/2095-8811; https://doaj.org/toc/2589-1081 |
| DOI: | 10.1002/wjo2.142 |
| Access URL: | https://doaj.org/article/a6ed7101417e4ad6a250e53333120a53 |
| Accession Number: | edsdoj.6ed7101417e4ad6a250e53333120a53 |
| Database: | Directory of Open Access Journals |
| ISSN: | 25891081 20958811 |
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| DOI: | 10.1002/wjo2.142 |
| Published in: | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| Language: | English |