Risk for Gastric Cancer after Antibiotic Prophylaxis in Patients Undergoing Hip Replacement

Katja Akre; Lisa B. Signorello; Lars Engstrand; Reinhold Bergström; Sune Larsson; Bengt I. Eriksson; Olof Nyrén

DOI: Published November 2000

Article Figures & Data

Tables

Table 1

Characteristics of 174 case patients with gastric cancer and 462 individually matched control subjects without gastric cancer in the Swedish cohort of 39,154 patients undergoing hip replacement surgery

Characteristic	No. of cases (% of total)	Controls
Age (yrs)
<65	37 (21)	100 (22)
65–69	37 (21)	100 (22)
70–74	49 (28)	137 (30)
≥75	51 (29)	125 (27)
Gender
Female	74 (43)	286 (62)
Male	100 (57)	176 (38)
Indication for index surgery^a
Osteoarthritis	114 (66)	307 (66)
Acute fracture	8 (5)	31 (7)
Late sequelae after fracture	48 (28)	103 (22)
Rheumatoid arthritis	7 (4)	22 (5)
Other	6 (3)	16 (3)
No. of surgeries^b
1	134 (77)	361 (78)
2	33 (19)	85 (18)
≥3	7 (4)	16 (3)
History of gastric resection
No	159 (91)	447 (97)
Yes	15 (9)	15 (3)
Mean follow-up time (years)	5.37	5.40
Median duration of antibiotic treatment (days)	8	9

a More than one indication was allowed, thus numbers exceed the total.
b The number of surgeries during follow-up includes index surgery.

Table 2

Conditional logistic regression-derived crude and adjusted ORs and 95% CIs for the association between the studied variables and gastric cancer

Variables	Number		Crude		Adjusted
Variables	Cases (n = 174)	Controls (n = 462)	OR	95% CI	OR^a	95% CI
Long-term antibiotic treatment before surgery
No	167	414	Ref.^c		Ref.
Yes	7	48	0.3	0.2–0.8	0.3	0.1–0.7
Prophylactic antibiotic treatment^b
No	44	90	Ref.		Ref.
Yes	129	367	0.7	0.4–1.1	0.7	0.5–1.1
Maximum prophylactic antibiotic dose per day^b
None	44	90	Ref.		Ref.
Below median (3 DDD)	66	178	0.7	0.5–1.2	0.7	0.4–1.2
Above median	62	183	0.7	0.4–1.1	0.7	0.4–1.2
Weight-adjusted maximum prophylactic antibiotic dose^b
None	24	48	Ref.		Ref.
Below median (0.04 DDD/kg)	52	125	0.7	0.4–1.4	0.7	0.3–1.4
Above median	43	133	0.5	0.2–1.0	0.5	0.2–1.1
						P for trend = 0.13
Cumulative prophylactic antibiotic dose^b
None	44	90	Ref.		Ref.
Below median (15.5 DDD)	59	182	0.7	0.4–1.1	0.7	0.4–1.1
Above median	63	177	0.7	0.4–1.1	0.7	0.4–1.2
Weight-adjusted cumulative prophylactic antibiotic dose^b
None	24	48	Ref.		Ref.
Below median (0.21 DDD/kg)	45	128	0.7	0.3–1.4	0.7	0.3–1.4
Above median	45	130	0.5	0.3–1.1	0.6	0.3–1.2
						P for trend = 0.29
Regular use of aspirin before surgery
No	133	334	Ref.		Ref.
Yes	41	128	0.8	0.5–1.2	0.8	0.5–1.2

a Adjusted for gender, age, history of gastric resection, and regular use of aspirin.
b Frequencies do not sum to total because of missing data.
c Ref., referent group.

Table 3

Conditional logistic regression-derived ORs^a and 95% CIs for the association of prophylactic antibiotic treatment, regular use of aspirin and gastric cancer, stratified by follow-up time

Years of follow-up		No. of		OR	95% CI
Years of follow-up		Cases	Controls	OR	95% CI
A. Prophylactic antibiotic treatment^a
<5	No	23	51	Ref.^c
	Yes	65	177	0.8	0.4–1.4
≥5	No	21	39	Ref.
	Yes	64	190	0.6	0.3–1.2
B. Regular use of aspirin^b
	No	71	166	Ref.
<5	Yes	17	66	0.6	0.3–1.1
≥5	No	62	168	Ref.
	Yes	24	62	1.0	0.6–1.9

a Adjusted for gender, age, history of gastric resection, and regular use of aspirin.
b Adjusted for gender, age, history of gastric resection, and prophylactic antibiotic treatment.
c Ref., referent group.

Table 4
Evaluation of the joint impact of use of aspirin and prophylactic antibiotics on gastric cancer risk: adjusted^a conditional logistic regression-derived ORs and 95% CIs

Aspirin Maximum antibiotic dose
No Below median Above median
No 1.00 (Ref.)^b 0.6 (0.3–1.0) 0.6 (0.3–1.1)
Yes 0.4 (0.2–1.2) 0.6 (0.3–1.2) 0.5 (0.2–1.0)

a Adjusted for gender, age, and history of gastric resection.

b Data are given as OR (95% CI). Ref., referent group.