Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2020 Sep;12(3):343-352. doi: 10.4055/cios20021. Epub 2020 Aug 19.
Limited information is available about the proportion of patients with degenerative lumbar spinal disease (DLSD) who have gastrointestinal (GI) and cardiovascular (CV) risk factors. Many DLSD patients are prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) that are known to carry risks to the GI and CV systems by increasing GI bleeding and thromboembolic events. This study aimed to measure the prevalence of GI and CV risk in patients with DLSD and to ascertain whether the prescription of NSAIDs is in line with current guidelines.
This study included 153 patients with symptomatic DLSD who were planning to undergo lumbar spinal surgery. The GI profile was checked using the GI Standardized Calculator of Risk for Event system and CV risk was evaluated using the presence of metabolic syndrome. The conformity of the prescription of NSAIDs was investigated according to the recommendations in current guidelines.
More than half of the patients (59.5%) had high or very high GI risk, and 66% of the patients were diagnosed with metabolic syndrome, which corresponds with CV risk. The rate of simultaneous GI and CV risk was 40.5% (n = 62 / 153; gastrointestinal Standardized Calculator of Risk for Event, > high and metabolic syndrome, yes). The actual prescription of NSAIDs was not in accordance with current guidelines.
Two out of 3 patients had GI or CV risk factors, and approximately 40% of patients had both. Detailed assessment of GI and CV risk in patients with DLSD by using effective evaluation tools is mandatory for optimal medical treatment.
关于患有退行性腰椎疾病（DLSD）的患者中有多少患有胃肠道（GI）和心血管（CV）危险因素的信息有限。许多 DLSD 患者被开处非甾体抗炎药（NSAIDs），已知这些药物会增加胃肠道出血和血栓栓塞事件的风险，从而对 GI 和 CV 系统造成风险。本研究旨在测量 DLSD 患者的 GI 和 CV 风险的流行率，并确定 NSAIDs 的处方是否符合当前指南。
本研究包括 153 名计划接受腰椎脊柱手术的有症状的 DLSD 患者。使用 GI 标准化风险计算器系统检查 GI 概况，使用代谢综合征评估 CV 风险。根据当前指南中的建议，研究了 NSAIDs 处方的一致性。
超过一半的患者（59.5%）具有高或极高的 GI 风险，并且 66%的患者被诊断患有代谢综合征，这与 CV 风险相对应。同时存在 GI 和 CV 风险的发生率为 40.5%（n = 62/153；胃肠道标准化风险计算器，>高和代谢综合征，是）。实际的 NSAIDs 处方不符合当前指南。
每 3 个患者中就有 2 个有 GI 或 CV 危险因素，约 40%的患者同时存在这两种危险因素。通过使用有效的评估工具对 DLSD 患者的 GI 和 CV 风险进行详细评估，对于最佳的医疗治疗是必要的。
