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Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia

INTRODUCTION: Atypical antipsychotics are commonly used in patients with psychiatric conditions and dementia. They are also frequently used in patients being admitted with pneumonia; however, there are few safety data. The purpose of this study was to examine whether atypical antipsychotic use prior...

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Autores principales: Boivin, Zachary, Perez, Mario F., Atuegwu, Nkiruka C., Metersky, Mark, Alvarez, Carlos A., Anzueto, Antonio, Mortensen, Eric M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826252/
https://www.ncbi.nlm.nih.gov/pubmed/31720299
http://dx.doi.org/10.1183/23120541.00223-2018
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author Boivin, Zachary
Perez, Mario F.
Atuegwu, Nkiruka C.
Metersky, Mark
Alvarez, Carlos A.
Anzueto, Antonio
Mortensen, Eric M.
author_facet Boivin, Zachary
Perez, Mario F.
Atuegwu, Nkiruka C.
Metersky, Mark
Alvarez, Carlos A.
Anzueto, Antonio
Mortensen, Eric M.
author_sort Boivin, Zachary
collection PubMed
description INTRODUCTION: Atypical antipsychotics are commonly used in patients with psychiatric conditions and dementia. They are also frequently used in patients being admitted with pneumonia; however, there are few safety data. The purpose of this study was to examine whether atypical antipsychotic use prior to admission is associated with increased mortality in patients with pneumonia. METHODS: We conducted a retrospective cohort study of hospitalised patients with pneumonia over a 10-year period. We included patients 65 years or older and hospitalised with pneumonia. For our primary analysis, we used propensity score matching to balance confounders between atypical antipsychotic users and nonusers. RESULTS: There were 102 897 patients and 5977 were taking atypical antipsychotics. After matching there were 5513 users and 5513 nonusers. Atypical antipsychotic use was associated with increased odds of 30-day (OR 1.20, 95% CI 1.11–1.31) and 90-day mortality (1.19, 1.09–1.30). CONCLUSION: In patients 65 years or older that are hospitalised with pneumonia, we found an association between atypical antipsychotic use and increased odds of mortality. This was particularly pronounced for patients with pre-existing psychiatric or cardiac conditions. We suggest closely monitoring patients who use these medications and minimising their use in older adult patients.
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spelling pubmed-68262522019-11-12 Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia Boivin, Zachary Perez, Mario F. Atuegwu, Nkiruka C. Metersky, Mark Alvarez, Carlos A. Anzueto, Antonio Mortensen, Eric M. ERJ Open Res Original Articles INTRODUCTION: Atypical antipsychotics are commonly used in patients with psychiatric conditions and dementia. They are also frequently used in patients being admitted with pneumonia; however, there are few safety data. The purpose of this study was to examine whether atypical antipsychotic use prior to admission is associated with increased mortality in patients with pneumonia. METHODS: We conducted a retrospective cohort study of hospitalised patients with pneumonia over a 10-year period. We included patients 65 years or older and hospitalised with pneumonia. For our primary analysis, we used propensity score matching to balance confounders between atypical antipsychotic users and nonusers. RESULTS: There were 102 897 patients and 5977 were taking atypical antipsychotics. After matching there were 5513 users and 5513 nonusers. Atypical antipsychotic use was associated with increased odds of 30-day (OR 1.20, 95% CI 1.11–1.31) and 90-day mortality (1.19, 1.09–1.30). CONCLUSION: In patients 65 years or older that are hospitalised with pneumonia, we found an association between atypical antipsychotic use and increased odds of mortality. This was particularly pronounced for patients with pre-existing psychiatric or cardiac conditions. We suggest closely monitoring patients who use these medications and minimising their use in older adult patients. European Respiratory Society 2019-11-04 /pmc/articles/PMC6826252/ /pubmed/31720299 http://dx.doi.org/10.1183/23120541.00223-2018 Text en Copyright ©ERS 2019 http://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Original Articles
Boivin, Zachary
Perez, Mario F.
Atuegwu, Nkiruka C.
Metersky, Mark
Alvarez, Carlos A.
Anzueto, Antonio
Mortensen, Eric M.
Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia
title Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia
title_full Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia
title_fullStr Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia
title_full_unstemmed Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia
title_short Association of atypical antipsychotics and mortality for patients hospitalised with pneumonia
title_sort association of atypical antipsychotics and mortality for patients hospitalised with pneumonia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826252/
https://www.ncbi.nlm.nih.gov/pubmed/31720299
http://dx.doi.org/10.1183/23120541.00223-2018
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