Anti-inflammatory drugs, analgesics and the risk of perforated XXXX .

@entity1 @entity66 @entity1049 @entity288
BACKGROUND: Acute perforated @entity1049 has a mortality rate of up to 30 per cent, but little is known about its aetiology. The aim of this study was to test the hypothesis that three classes of drugs, namely non-steroidal anti-inflammatory drugs (NSAIDs), opioid analgesics and @entity288 , are risk factors for perforated @entity66 . METHODS: All @entity1 with confirmed perforated @entity1049 were identified over a 5-year period in two hospitals in Norfolk, UK. Two control groups were selected and matched for age, sex and hospital of admission. Data on medication use were obtained from hospital records. Odds ratios for each drug were calculated using conditional logistic regression. RESULTS: Opioid analgesics, NSAIDs and @entity288 were all positively associated with perforated @entity1049 . The odds ratio for opioid analgesics was 1.8 (95 per cent confidence interval (c.i.) 1.1 to 3.0) in the analysis with ophthalmology controls and 3.1 (95 per cent c.i. 1.8 to 5.5) in that with dermatology controls. Respective odds ratios for NSAIDs were 4.0 (95 per cent c.i. 2.1 to 7.6) and 3.7 (95 per cent c.i. 2.0 to 6.8), and those for @entity288 were 5.7 (95 per cent c.i. 2.2 to 14.4) and 7.8 (95 per cent c.i. 2.6 to 23.3). CONCLUSION: Opioid analgesics, NSAIDs and @entity288 are all positively associated with perforated @entity1049 . The consistency of these associations, together with plausible biological mechanisms, suggests that these drugs may have a causative role in this condition.
