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Association of Atypical Antipsychotics and Mortality for Patients Hospitalized with Pneumonia
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A2618 - Association of Atypical Antipsychotics and Mortality for Patients Hospitalized with Pneumonia
Author Block: E. M. Mortensen, Z. Boivin, M. F. Perez, N. Atuegwu, M. L. Metersky; UConn Health, Farmington, CT, United States.
Background: The use of some antipsychotics has been associated with higher mortality in elderly patients with dementia. These medications, especially the newer antipsychotics known as atypical antipsychotics, are commonly used in patients with psychiatric conditions as well as dementia. The purpose of this study was to examine whether use of atypical antipsychotics prior to hospital admission is associated with increased mortality in older patients hospitalized with pneumonia. Methods: We conducted a retrospective cohort study of hospitalized patients with pneumonia at any Departments of Veterans Affairs (VA) hospital over a 10-year period. We included patients 65 years or older who consistently received VA care. We used multilevel regression models to examine the association of atypical antipsychotics and mortality after controlling for potential confounders including age, sex, sociodemographic factors, comorbid conditions, and other medications. Results: Our cohort had 103,997 patients and 5,977 were taking atypical antipsychotics. After adjusting for potential confounders, atypical antipsychotic use was associated with an increased odds of 30-day (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.16-1.38), and 90-day (OR 1.31, 95% CI 1.22-1.40) mortality. There was also an increased odds of 30-day and 90-day mortality in subgroups of patients with preexisting psychiatric conditions (OR 1.13, 95% CI 1.01-1.27), (OR 1.12, 95% CI 1.02-1.24) and preexisting cardiac conditions (OR 1.30, 95% CI 1.14-1.48), (OR 1.38, 95% CI 1.23-1.54) respectively. However, we found that atypical antipsychotics were not associated with an increased odds of cardiovascular events (OR 0.83, 95% CI 0.75-0.91). Conclusion: Prior use of atypical antipsychotics are associated with an increased odds of mortality in elderly patients 65 years or older that are hospitalized with pneumonia. Therefore, clinicians should consider these findings when using atypical antipsychotics in those patients at risk for pneumonia.
Author Block: E. M. Mortensen, Z. Boivin, M. F. Perez, N. Atuegwu, M. L. Metersky; UConn Health, Farmington, CT, United States.
Background: The use of some antipsychotics has been associated with higher mortality in elderly patients with dementia. These medications, especially the newer antipsychotics known as atypical antipsychotics, are commonly used in patients with psychiatric conditions as well as dementia. The purpose of this study was to examine whether use of atypical antipsychotics prior to hospital admission is associated with increased mortality in older patients hospitalized with pneumonia. Methods: We conducted a retrospective cohort study of hospitalized patients with pneumonia at any Departments of Veterans Affairs (VA) hospital over a 10-year period. We included patients 65 years or older who consistently received VA care. We used multilevel regression models to examine the association of atypical antipsychotics and mortality after controlling for potential confounders including age, sex, sociodemographic factors, comorbid conditions, and other medications. Results: Our cohort had 103,997 patients and 5,977 were taking atypical antipsychotics. After adjusting for potential confounders, atypical antipsychotic use was associated with an increased odds of 30-day (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.16-1.38), and 90-day (OR 1.31, 95% CI 1.22-1.40) mortality. There was also an increased odds of 30-day and 90-day mortality in subgroups of patients with preexisting psychiatric conditions (OR 1.13, 95% CI 1.01-1.27), (OR 1.12, 95% CI 1.02-1.24) and preexisting cardiac conditions (OR 1.30, 95% CI 1.14-1.48), (OR 1.38, 95% CI 1.23-1.54) respectively. However, we found that atypical antipsychotics were not associated with an increased odds of cardiovascular events (OR 0.83, 95% CI 0.75-0.91). Conclusion: Prior use of atypical antipsychotics are associated with an increased odds of mortality in elderly patients 65 years or older that are hospitalized with pneumonia. Therefore, clinicians should consider these findings when using atypical antipsychotics in those patients at risk for pneumonia.
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