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Published on: September 24, 2020
Prehospital NSAIDs use prolong hospitalization in patients with pleuro-pulmonary infection
Ourania S Kotsiou1, Sotirios G Zarogiannis2, Konstantinos I Gourgoulianis1
1Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
Objective:
Nonsteroidal anti-inflammatory drug (NSAID) pre-hospitalization consumption might affect the course of pneumonia. We opted to assess the potential effects of pre-hospitalization use of NSAIDs in patients with pleuropulmonary infection in the context of the duration of hospitalization.
Methods:
A prospective observational study of 57 consecutive patients with a diagnosis of pneumonia and parapneumonic pleural effusion was conducted. The exact medication history the previous fifteen days was recorded.
Results:
Prehospital use of NSAIDs >6 days was positively associated with prolonged hospitalization extending out for approximately 10 days. Immunosuppression was an independent risk factor for prolonged hospitalization of more than 5 days. This group of patients also had more complicated pleural effusions and difficult to treat management. In the immunocompetent group of patients, there was a negative inverse correlation of duration of NSAIDs use with pleural fluid pH and glucose. The longer medication with NSAIDs correlated with lower values of C-reactive protein, and erythrocyte sedimentation rate. Importantly, the early prehospital antibiotic use significantly prevented the development of empyema.
Conclusion:
Our findings highlight the potential complications involved with prehospital use of NSAIDs and especially that prolonged NSAID use which may lead to longer hospitalization duration and more complicated pleural effusions.
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