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Open Access Research article

Use of selective serotonin reuptake inhibitors and risk of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study

Rune Gärtner1, Deirdre Cronin-Fenton2, Heidi H Hundborg23, Lars Pedersen2, Timothy L Lash24, Henrik Toft Sørensen2* and Niels Kroman1

Author Affiliations

1 Department of Breast Surgery, Rigshospitalet, University of Copenhagen, Blegdamsvej 9 Copenhagen Ø 2100, Denmark

2 Department of Clinical Epidemiology, Aarhus University Hospital. Olof Palmes Alle 43-45, Aarhus N 8200, Denmark

3 National Centre for Register-based Research, University of Aarhus, Aarhus, Denmark

4 Department of Epidemiology, Boston University School of Public Health, 715 Albany St. Boston, MA 02118, USA

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BMC Surgery 2010, 10:3  doi:10.1186/1471-2482-10-3

Published: 24 January 2010

Abstract

Background

Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association.

Methods

We conducted a population-based study of the risk of re-operation due to post-surgical bleeding within two weeks of primary surgery among Danish women with primary breast cancer. Patients were categorised according to their use of SSRI: never users, current users (SSRI prescription within 30 days of initial breast cancer surgery), and former users (SSRI prescription more than 30 days before initial breast cancer surgery). We calculated the risk of re-operation due to post-surgical bleeding within 14 days of initial surgery, and the relative risk (RR) of re-operation comparing SSRI users with never users of SSRI adjusting for potential confounders.

Results

389 of 14,464 women (2.7%) were re-operated. 1592 (11%) had a history of SSRI use. Risk of re-operation was 2.6% among never users, 7.0% among current SSRI users, and 2.7% among former users. Current users thus had an increased risk of re-operation due to post-operative bleeding (adjusted relative risk = 2.3; 95% confidence interval (CI) = 1.4, 3.9) compared with never users. There was no increased risk of re-operation associated with former use of SSRI (RR = 0.93, 95% CI = 0.66, 1.3).

Conclusions

Current use of SSRI is associated with an increased risk of re-operation due to bleeding after surgery for breast cancer.