• Milo C Engoren, Robert H Habib, Anoar Zacharias, John Dooner, Thomas A Schwann, Christopher J Riordan, Samuel J Durham, and Aamir Shah.
• Department of Anesthesiology, Medical University of Ohio, Toledo, OH, USA. engoren@pol.net <engoren@pol.net>
• J. Cardiothorac. Vasc. Anesth. 2007 Dec 1;21(6):820-6.

ObjectiveThis study was designed to determine the effect of ketorolac on mortality after cardiac surgery.DesignA retrospective multivariable analysis with propensity matching and propensity scoring.SettingA tertiary care university-affiliated medical center.ParticipantEleven hundred eighty-six patients undergoing isolated coronary artery bypass surgery.Main ResultsBetween January 1, 2002, and November 1, 2004, 168 patients undergoing isolated coronary artery bypass surgery received ketorolac, whereas 1,018 patients did not. There were 2 deaths (1%) in the ketorolac group compared with 104 (10%) in the nonketorolac group (p < 0.001). Within 90 days of surgery, there was 1 death (1%) in the ketorolac group compared with 51 (5%) in the nonketorolac group (p = 0.01). By Cox modeling, ketorolac use was associated with a 7-fold lower risk of death (p = 0.02). In the patients who survived at least 90 days, there was 1 death (1%) in the ketorolac group compared with 53 (5%) in the nonketorolac group (p = 0.01). By Cox modeling, ketorolac use was associated with a 2.4-fold lower risk of death (p = 0.03) in the late hazard period. In the propensity-matched groups, Kaplan-Meier survival was better in patients who received ketorolac (p = 0.02).ConclusionThe use of ketorolac was associated with a statistically significant decrease in mortality at follow-up.

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