Perioperative flurbiprofen axetil use and postoperative intestinal complications in elderly patients undergoing radical colorectal surgery

Objective To investigate the association between perioperative flurbiprofen axetil administration and postoperative intestinal complications in elderly patients undergoing radical colorectal surgery. Methods We retrospectively reviewed the medical records of elderly patients who underwent primary radical colorectal surgery at Peking University People’s Hospital between November 2018 and March 2022. Data on patient demographics, surgical characteristics, perioperative medication use, and postoperative intestinal complications were collected. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with postoperative intestinal complications. To minimize potential confounding, inverse probability of treatment weighting (IPTW) based on propensity scores was applied. Results A total of 453 patients were included in the final analysis, among whom 54 (11.9%) developed postoperative intestinal complications. These complications comprised postoperative ileus (36 pts, 7.9%), anastomotic leakage (17 pts, 3.8%), and chylous fistula (3 pts, 0.7%). Perioperative flurbiprofen axetil use was significantly associated with a higher risk of postoperative intestinal complications ( P = 0.002; odds ratio [OR] = 3.005, 95% confidence interval [CI]: 1.487–6.072). After adjustment for baseline demographic characteristics and comorbidities using IPTW, flurbiprofen axetil administration remained independently associated with an approximately threefold increased risk of intestinal complications (IPTW-adjusted P = 0.005; odds ratio = 3.263, 95% confidence interval: 1.429–7.452). Conclusion Perioperative use of flurbiprofen axetil may be associated with an increased risk of postoperative intestinal complications in elderly patients undergoing radical colorectal surgery. Further prospective studies with larger sample sizes and dose-stratified analyses are warranted to confirm these findings and clarify the underlying mechanisms.