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Nonsteroidal Anti-inflammatory Drugs Are Not Associated With Increased Bleeding in Blunt Solid Organ Injury
Joshua H Hill1, Jamie Kuhlman, Aimee LaRiccia
1Division of Trauma and Acute Care Surgery, OhioHealth Grant Medical Center, Columbus, Ohio (Drs Hill, LaRiccia, Hyland, and Spalding and Mss Kuhlman and Ngo); Department of Surgery, OhioHealth Doctors Hospital, Columbus, Ohio (Drs Hill, LaRiccia, and Spalding); Department of Pharmacy Services, OhioHealth Grant Medical Center, Columbus, Ohio (Dr Hyland); and Ohio University Heritage College of Osteopathic Medicine, Dublin (Mss Kuhlman and Ngo).
Nonsteroidal anti-inflammatory drugs (NSAIDs) did not increase bleeding in patients with blunt solid organ injuries. These patients were less likely to need surgery or embolization when treated with NSAIDs.
Area of Science:
- Trauma surgery
- Pain management
- Pharmacology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective non-opiate pain relievers.
- Concerns exist regarding NSAID cyclooxygenase-1 (COX-1) inhibition and potential bleeding exacerbation in solid organ injuries.
Purpose of the Study:
- To evaluate the impact of NSAIDs on blunt solid organ injury.
- To test the hypothesis that NSAIDs do not worsen intra-abdominal bleeding progression.
Main Methods:
- Retrospective cohort study of blunt solid organ injury patients (June 2015-June 2019).
- Compared patients receiving NSAIDs versus those not receiving NSAIDs.
- Assessed intra-abdominal bleeding progression via surgical intervention, angioembolization, and blood transfusions.
Main Results:
- Analyzed 706 patients; 206 received NSAIDs.
- NSAID group had lower odds of operation (OR 0.46) and embolization (OR 0.27).
- No significant difference in packed red blood cell transfusion needs between groups.
Conclusions:
- NSAID use was associated with decreased likelihood of organ-specific procedures or blood transfusions.
- No increased risk of adverse events related to intra-abdominal bleeding was observed.
- NSAIDs did not increase mortality in patients with blunt solid organ injuries.
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