February 1, 2003Stroke61 citations
Nonaspirin Nonsteroidal Anti-Inflammatory Drugs and Risk of Hospitalization for Intracerebral Hemorrhage
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Key Result
Prescription of nonaspirin NSAIDs in the preceding 30 to 90 days was not associated with an increased risk of intracerebral hemorrhage (ORs ranging from 0.92 to 1.13).
Key Points
- To evaluate the relationship between nonaspirin NSAID use and hospitalization risk for intracerebral hemorrhage (ICH).
- Identified 912 ICH cases and 9059 matched controls from 1991-1999 using population databases.
- Examined prescriptions for nonaspirin NSAIDs before ICH admission through a prescription database.
- Adjusted for confounding factors using conditional logistic regression.
- No overall association found between nonaspirin NSAID prescription and ICH risk; odds ratios ranged from 0.92 to 1.13.
- No increased risk observed in subgroups based on age, sex, or previous hypertension diagnosis.
Study Design
Type
Case-Control (n=9,971)
Multicenter
No
Structured PICO
Does the use of nonaspirin NSAIDs increase the risk of hospitalization for intracerebral hemorrhage?
P
Population
9,971 individuals, comprising 912 cases of first-time intracerebral hemorrhage and 9,059 matched controls, evaluated between 1991 and 1999.
E
Exposure
Prescription for nonaspirin NSAIDs in the preceding 30, 60, or 90 days
C
Comparator
No prescription for nonaspirin NSAIDs
O
Outcome
Hospitalization for first-time intracerebral hemorrhage (ICH)safety
Prescription of nonaspirin NSAIDs is not associated with an increased risk of hospitalization for intracerebral hemorrhage, even in high-risk subgroups like the elderly and those with hypertension.
Main Result
Effect estimate: OR 0.92 to 1.13 (95% CI 0.70-1.21 to 0.81-1.58)
Abstract
BACKGROUND AND PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) have effects on hemostasis and have been associated with an increased risk of bleeding. However, data relating the use of nonaspirin NSAIDs and risk of intracerebral hemorrhage (ICH) are sparse. METHODS: Using data from the County Hospital Patient Register and the Civil Registration System of North Jutland County, Denmark, we identified 912 cases of first-time ICH and 9059 sex- and age-matched population-based controls in the period of 1991 to 1999. All prescriptions for nonaspirin NSAIDs before the date of admission for ICH were identified through a population-based prescription database. Conditional logistic regression was used to adjust for potential confounding factors, including previous discharge diagnoses of hypertension, chronic bronchitis and emphysema, alcoholism, liver cirrhosis, diabetes mellitus, and prescriptions for insulin or oral hypoglycemic agents, antihypertensive agents, lipid-lowering agents, low-dose aspirin, high-dose aspirin, and oral anticoagulants. RESULTS: No overall association was found between prescription for nonaspirin NSAIDs in the preceding 30, 60, or 90 days and risk of ICH; ie, odds ratios ranged from 0.92 (95% CI, 0.70 to 1.21) to 1.13 (95% CI, 0.81 to 1.58). Furthermore, there was no increased risk of ICH associated with prescription for nonaspirin NSAIDs when the study population was stratified by age, sex, and a previous discharge diagnosis of hypertension. CONCLUSIONS: Patients prescribed nonaspirin NSAIDs were not at an overall increased risk of being hospitalized for ICH. This reassuring finding was seen in all examined subgroups, including the elderly and patients with a previous discharge diagnosis of hypertension.