Figures
- FIGURE 1
Survival curves demonstrating a statistically significant (p=0.001) association with increased mortality in those receiving atypical antipsychotics in the entire cohort.
Tables
- TABLE 1
Comparison of propensity-matched atypical antipsychotic users and nonusers hospitalised with pneumonia
Variables Atypical antipsychotics (N=5513) No atypical antipsychotics (N=5513) p-value Standardised difference Age groups 0.6 0.02 65–74 years 2024 (36.7%) 2011 (36.5%) 75–84 years 2427 (44.0%) 2382 (43.2%) 85–94 years 1031 (18.7%) 1085 (19.7%) 95 years and above 31 (0.6%) 35 (0.6%) Men 5404 (98.0%) 5399 (97.9%) 0.7 −0.006 White 4485 (81.4%) 4454 (81.0%) 0.5 −0.01 Black 641 (11.6%) 678 (12.3%) 0.3 0.02 Hispanic 685 (12.4%) 684 (12.4%) 0.9 −0.0005 Nursing home residence 165 (3.0%) 153 (2.8%) 0.5 −0.01 VA priority group 0.4 −0.02 Group 1 1876 (34.0%) 1895 (34.4%) Groups 2–6 3303 (60.0%) 3318 (60.2%) Groups 7–8 334 (6.0%) 300 (5.4%) Primary care visits in the year prior 5.4±5.1 5.4±4.6 0.6 −0.01 Intensive care unit admission 867 (15.7%) 837 (15.2%) 0.4 −0.02 Invasive mechanical ventilation 333 (6.0%) 341 (6.2%) 0.8 0.006 Vasopressors 275 (5.0%) 280 (5.1%) 0.8 0.004 Inpatient guideline concordant antibiotics# 4334 (78.6%) 4343 (78.8%) 0.8 0.004 Tobacco use/cessation 2330 (42.3%) 2278 (41.3%) 0.3 −0.02 Alcohol abuse 504 (9.1%) 499 (9.1%) 0.9 −0.003 Illicit drug abuse 219 (4.0%) 203 (3.7%) 0.4 −0.02 Myocardial infarction 375 (6.8%) 395 (7.2%) 0.5 0.01 Heart failure 1221 (22.2%) 1251 (22.7%) 0.5 0.01 Peripheral vascular disease 737 (13.4%) 756 (13.7%) 0.6 0.01 COPD 2567 (46.6%) 2515 (45.6%) 0.3 −0.01 Stroke 1367 (24.8%) 1406 (25.5%) 0.4 0.01 Rheumatologic disease 93 (1.7%) 102 (1.9%) 0.5 0.002 Mild liver disease 47 (0.9%) 40 (0.7%) 0.5 −0.003 Peptic ulcer disease 178 (3.2%) 180 (3.3%) 0.9 0.002 Dementia 1146 (21.0%) 1111 (20.1%) 0.4 −0.01 Diabetes 1827 (33.1%) 1845 (33.5%) 0.7 0.007 Diabetes with complications 554 (10.1%) 572 (10.4%) 0.6 0.01 Moderate liver disease 21 (0.4%) 20 (0.4%) 0.9 −0.01 Renal disease 782 (14.2%) 804 (14.6%) 0.6 −0.009 Any prior malignancy 996 (18.1%) 977 (17.7%) 0.6 −0.009 Metastatic solid tumour 148 (2.7%) 250 (2.7%) 0.9 0.002 Hematologic malignancy 77 (1.4%) 73 (1.3%) 0.7 −0.006 HIV 4 (0.1%) 4 (0.1%) 1.0 0.00 Psychiatric conditions¶ 1.09±0.98 1.10±1.0 0.33 0.02 Prior outpatient antibiotics 1445 (26.2%) 1458 (26.5%) 0.8 0.005 Antidepressants 3049 (55.3%) 2922 (53.0%) 0.1 −0.04 Lithium 49 (0.9%) 46 (0.8%) 0.8 −0.006 Statins 1935 (35.0%) 1968 (35.5%) 0.4 0.01 ARB 226 (4.1%) 220 (4.0%) 0.99 −0.004 ACE inhibitors 1745 (31.6%) 1768 (32.0%) 0.9 0.009 Antiarrhythmics 133 (2.4%) 137 (2.5%) 0.6 0.006 Β-blockers 1910 (34.6%) 1851 (33.6%) 0.4 −0.02 Calcium channel blockers 1255 (22.8%) 1261 (22.9%) 0.7 0.002 Oral antidiabetics 654 (11.9%) 608 (11.0%) 0.2 −0.02 Other lipid-lowering medications 244 (0.05%) 252 (0.05%) 0.8 0.007 Other antihypertensive medications 1206 (21.9%) 1207 (21.9%) 0.8 −0.002 Inhaled β-agonists 1670 (30.2%) 1603 (29.0%) 0.1 −0.008 Other inhaled medications 1617 (29.3%) 1575 (28.1%) 0.4 −0.0003 Theophylline 93 (1.7%) 89 (1.6%) 0.8 −0.006 Data are presented as mean±sd or n (%) unless otherwise stated. VA: Dept of Veterans Affairs; ARB: angiotensin II receptor blocker; ACE: angiotensin-converting enzyme. #: concordant with 2007 American Thoracic Society/Infectious Diseases Society of America clinical practice guideline for community-acquired pneumonia [26]. ¶: Selim psychiatric conditions.
- TABLE 2
Results of the adjusted multilevel regression models for secondary analyses
Subgroup Patients 90-day mortality OR (95% CI) Entire cohort 102 976 1.31 (1.22–1.40) Dementia 5156 0.96 (0.82–1.12) Psychiatric conditions# 26 006 1.21 (1.12–1.30) Pre-existing cardiac conditions¶ 36 379 1.22 (1.09–1.36) Intensive care unit admission 17 738 0.96 (0.82–1.12) #: post-traumatic stress disorder, schizophrenia, bipolar disorder and depression; ¶: myocardial infarction, heart failure and cardiac arrhythmias.
