NIMRA-survey: NSAIDs impact on mortality. Results of an Austrian Survey in 2006.
This survey is based on a sample of over two thousand patients who were in the first eight months of the year 2006 hospitalised due to a diagnosis of coronary heart disease (CHD) or rheumatic diseases (RD). Their demographic, anamnestic data were assessed according to a prospectively defined analysis plan together with the associated mortality. The main survey questions--whether the data suggest an association between rheumatism as compared to CHD and mortality and which conclusions with respect to NSAID (non-steroidal anti-inflammatory drug) consumption can be drawn in this pilot project--can be answered with some degree of statistical robustness bearing in mind the sampling uncertainties and the omnipresent fuzziness of medical data including mortality. Rheumatism is generally associated with a lower risk of death (1%) as compared to CHD patients with a death risk of 3% (p < 0.01). As there are many confounding risk factors which show statistically highly significant effects and might be associated with substantial interactions on the mortality outcome it seems advisable to interpret the available data with caution and take this as the main results of a survey which is characterised mainly by its pilot nature. Additional research in this area with more sophisticated tools and based on much larger samples is judged to provide final and conclusive epidemiologic evidence. For the time being NSAIDs did not imply any relevant increases in mortality in RD or CHD patients as compared to patients who were not prescribed NSAIDs. Coronary heart diseases constitute a relevant and significant prognostic factor for an increased mortality as compared to rheumatic diseases.
Neumann
Kurt
K
VISEM - Vienna School of Evidence Based Medicine, Vienna, Austria. kurt.neumann@visem.org
D000206:Actuarial Analysis; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001317:Austria; D002423:Cause of Death; D015331:Cohort Studies; D003327:Coronary Disease / Q000188:drug therapy* / Q000401:mortality*; D005194:Family Practice; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000401:mortality*; D018570:Risk Assessment
D000894:Anti-Inflammatory Agents, Non-Steroidal