Prevalence of in-hospital nonsteroidal antiinflammatory drug exposure in patients with a primary diagnosis of heart failure

Cardiovasc Ther. 2017 Jun;35(3). doi: 10.1111/1755-5922.12256.

Abstract

Aim: To determine the prevalence of in-hospital nonsteroidal antiinflammatory drug (NSAID) exposure and associated outcomes in patients admitted with a primary diagnosis of heart failure.

Methods: We performed a propensity-matched cohort analysis of patients admitted to Houston Methodist Hospital System with a primary diagnosis of heart failure according to the International Classification of Diseases-9-Clinical Modification (ICD-9-CM) from January 1, 2011 to December 31, 2014.

Results: Of the 9742 patients admitted with a primary diagnosis of heart failure, 384 patients (3.9%) were exposed to NSAID. After applying propensity scores we matched 305 NSAID exposed with 915 unexposed patients. Patients with in-hospital NSAID exposure had a longer length of stay (7.0±8.8 days vs 6.1±8.5; P=.003) and increased prevalence of worsening renal function (34.4% vs 27.9%; P=.030). There were not statically significant differences in in-hospital mortality rate or 30-day all-cause readmission rate.

Conclusion: Exposure to NSAID in patients admitted with a primary diagnosis of heart failure was low but was associated with adverse outcomes including longer length of stay and higher prevalence or worsening renal function.

Keywords: Acute kidney injury; Antiinflammatory agents; Heart failure; Length of stay; Nonsteroidal; Patient readmission; Pharmacoepidemiology.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Chi-Square Distribution
  • Drug Administration Schedule
  • Female
  • Heart Failure / diagnosis*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Heart Failure / therapy
  • Hospital Mortality
  • Hospitalization*
  • Humans
  • Kidney / drug effects
  • Kidney / physiopathology
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Readmission
  • Prognosis
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • Texas
  • Time Factors

Substances

  • Anti-Inflammatory Agents, Non-Steroidal