Abstract
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.
Abstract
When hospitalised with pneumonia, older patients who use atypical antipsychotics should be monitored closely and their use of these drugs should be minimised as much as possible http://bit.ly/2JEevHV
Footnotes
Support statement: This project was supported by grant number R01NR010828 from the National Institute of Nursing Research. E.M. Mortensen was supported by 1R24HS022418-01 from the Agency for Health Care Research and Quality. C.A. Alvarez was supported by K08DK101602 from the National Institute of Diabetes and Digestive and Kidney Diseases. Funding information for this article has been deposited with the Crossref Funder Registry.
Conflict of interest: Z. Boivin has nothing to disclose.
Conflict of interest: M.F. Perez has nothing to disclose.
Conflict of interest: N.C. Atuegwu has nothing to disclose.
Conflict of interest: M. Metersky has nothing to disclose.
Conflict of interest: C.A. Alvarez has nothing to disclose.
Conflict of interest: A. Anzueto has nothing to disclose.
Conflict of interest: E.M. Mortensen has nothing to disclose.
- Received November 23, 2018.
- Accepted June 11, 2019.
- Copyright ©ERS 2019
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