BACKGROUND:
Nonsteroidal anti-inflammatory drugs are an effective nonopiate option for pain control. However, the antiplatelet aggregation of cyclooxygenase-1 (COX-1) inhibitors presents a concern in that they may exacerbate bleeding in patients with solid organ injuries.
OBJECTIVE:
The aim of the study is to evaluate the impact of nonsteroidal anti-inflammatory drugs on blunt solid organ injury. We hypothesized that nonsteroidal anti-inflammatory drugs would not contribute to intra-abdominal bleed progression.
METHODS:
This is a retrospective cohort study of blunt solid organ injury evaluated from June 1, 2015, to June 30, 2019, at an urban midwestern Level I trauma center. Patients receiving and those not receiving nonsterioidal anti-inflammatory drugs were compared on intra-abdominal bleeding progression as assessed by surgical intervention, angioembolization, and blood transfusions.
RESULTS:
We analyzed 706 patients, of whom 206 were given nonsteroidal anti-inflammatory drugs during their hospital course. Compared with those who were not given nonsteroidal anti-inflammatory drugs, patients given nonsteroidal anti-inflammatory drugs were less likely to have an operation (odds ratio, OR 0.46, 95% confidence interval, CI [0.25, 0.85], p = .012) and were less likely to have an embolization (OR 0.27, 95% CI [0.11, 0.70], p = .004). There was no difference in the need for packed red blood cell transfusion between the nonsteroidal anti-inflammatory drug and non- nonsteroidal anti-inflammatory drug groups (95% CI [0.91, 1.99], p = .13).
CONCLUSION:
Patients given nonsteroidal anti-inflammatory drugs had a decreased likelihood of receiving an organ-specific procedure or needing a blood transfusion and had no difference in mortality. Our findings indicate that nonsteroidal anti-inflammatory drugs in patients with blunt solid organ injuries were not associated with an increased risk of adverse events related to intra-abdominal bleeding.
Background/Objectives: Nearly 4 million women experience pregnancy every year in the United States. While there is research about medical outcomes related to pregnancy, especially in the context of disease, there is a dearth of research related to pregnancy expectations.
Methods: This qualitative study explored women’s expectations and experiences of pregnancy in Southeast Ohio. Participants attending a clinic were recruited for individual interviews onsite at the physician's office. Interviews were audio recorded and transcribed verbatim. Codes, in the form of descriptive labels such as words or brief phrases, were developed based on entire interviews.
Results: Results indicate that women experience pregnancy on a continuum, some women enjoyed the experience, some were ambivalent, while others did not enjoy the experience. Furthermore, some women reported that their expectations for pregnancy matched their experience(s), while others felt that their expectations did not match their experience. Some women also felt “judged” by other women and even health care providers if they did not “love” the experience.
Conclusions: Women experience pregnancy in a variety of ways, therefore, it is important that health care providers be sensitive to the notion that not all women enjoy the process, but they all want the same outcome of a healthy child. While it is important for health care providers to assess the physical health of the mother and the unborn child, this study demonstrated that it is also important to assess what an expectant mother knows about pregnancy and what she expects to happen.
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