Antipsychotic prescription and mortality in hospitalized older persons

Salvatore Corrao, Carlotta Franchi, Pier Mannuccio Mannucci, Codjo D. Djade, Maura Marcucci, Deborah Chiesa, Luca Pasina, Giuseppe Romanelli, Alessandra Marengoni, Mauro Tettamanti, Salvatore Corrao, Francesco Salerno, Alessandro Nobili

Risultato della ricerca: Article

1 Citazione (Scopus)

Abstract

Background: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Results: Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score â¥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score <5 (indicative of normal cognition). In-hospital mortality was slightly higher in patients prescribed antipsychotic drugs (14.3% vs 9.4%; P=0.109), but in multivariate analysis only male sex, older age, and higher SBT scores were significantly related to mortality during hospitalization. At 3-month follow-up, only male sex, older age, and higher SBT scores were associated with mortality. Conclusion: We found that the prescription of antipsychotic drugs during hospitalization was not associated with in-hospital or follow-up mortality. Short-term antipsychotic prescriptions (for acutely ill patients) may have a different effect than long-term, repeated prescriptions.
Lingua originaleEnglish
Numero di pagine9
RivistaPsychogeriatrics
Stato di pubblicazionePublished - 2017

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Antipsychotic Agents
Prescriptions
Mortality
Hospitalization
Prescription Drugs
Dementia
Logistic Models
Behavioral Symptoms
Haloperidol
Hospital Mortality
Cognition
Comorbidity
Inpatients
Multivariate Analysis
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cita questo

Corrao, S., Franchi, C., Mannucci, P. M., Djade, C. D., Marcucci, M., Chiesa, D., ... Nobili, A. (2017). Antipsychotic prescription and mortality in hospitalized older persons. Psychogeriatrics.

Antipsychotic prescription and mortality in hospitalized older persons. / Corrao, Salvatore; Franchi, Carlotta; Mannucci, Pier Mannuccio; Djade, Codjo D.; Marcucci, Maura; Chiesa, Deborah; Pasina, Luca; Romanelli, Giuseppe; Marengoni, Alessandra; Tettamanti, Mauro; Corrao, Salvatore; Salerno, Francesco; Nobili, Alessandro.

In: Psychogeriatrics, 2017.

Risultato della ricerca: Article

Corrao, S, Franchi, C, Mannucci, PM, Djade, CD, Marcucci, M, Chiesa, D, Pasina, L, Romanelli, G, Marengoni, A, Tettamanti, M, Corrao, S, Salerno, F & Nobili, A 2017, 'Antipsychotic prescription and mortality in hospitalized older persons', Psychogeriatrics.
Corrao S, Franchi C, Mannucci PM, Djade CD, Marcucci M, Chiesa D e altri. Antipsychotic prescription and mortality in hospitalized older persons. Psychogeriatrics. 2017.
Corrao, Salvatore ; Franchi, Carlotta ; Mannucci, Pier Mannuccio ; Djade, Codjo D. ; Marcucci, Maura ; Chiesa, Deborah ; Pasina, Luca ; Romanelli, Giuseppe ; Marengoni, Alessandra ; Tettamanti, Mauro ; Corrao, Salvatore ; Salerno, Francesco ; Nobili, Alessandro. / Antipsychotic prescription and mortality in hospitalized older persons. In: Psychogeriatrics. 2017.
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abstract = "Background: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Societ{\~A}  Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Results: Among 2703 patients included in the study, 135 (5{\%}) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38{\%} and 36{\%} of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71{\%} had an SBT score {\^a}¥10 (indicative of dementia), 12{\%} had an SBT score of 5-9 (indicative of questionable dementia); and 17{\%} had an SBT score <5 (indicative of normal cognition). In-hospital mortality was slightly higher in patients prescribed antipsychotic drugs (14.3{\%} vs 9.4{\%}; P=0.109), but in multivariate analysis only male sex, older age, and higher SBT scores were significantly related to mortality during hospitalization. At 3-month follow-up, only male sex, older age, and higher SBT scores were associated with mortality. Conclusion: We found that the prescription of antipsychotic drugs during hospitalization was not associated with in-hospital or follow-up mortality. Short-term antipsychotic prescriptions (for acutely ill patients) may have a different effect than long-term, repeated prescriptions.",
keywords = "Antipsychotics, Geriatrics and Gerontology, Gerontology, Hospitalization, Mortality, Older persons, Psychiatry and Mental Health",
author = "Salvatore Corrao and Carlotta Franchi and Mannucci, {Pier Mannuccio} and Djade, {Codjo D.} and Maura Marcucci and Deborah Chiesa and Luca Pasina and Giuseppe Romanelli and Alessandra Marengoni and Mauro Tettamanti and Salvatore Corrao and Francesco Salerno and Alessandro Nobili",
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TY - JOUR

T1 - Antipsychotic prescription and mortality in hospitalized older persons

AU - Corrao, Salvatore

AU - Franchi, Carlotta

AU - Mannucci, Pier Mannuccio

AU - Djade, Codjo D.

AU - Marcucci, Maura

AU - Chiesa, Deborah

AU - Pasina, Luca

AU - Romanelli, Giuseppe

AU - Marengoni, Alessandra

AU - Tettamanti, Mauro

AU - Corrao, Salvatore

AU - Salerno, Francesco

AU - Nobili, Alessandro

PY - 2017

Y1 - 2017

N2 - Background: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Results: Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score â¥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score <5 (indicative of normal cognition). In-hospital mortality was slightly higher in patients prescribed antipsychotic drugs (14.3% vs 9.4%; P=0.109), but in multivariate analysis only male sex, older age, and higher SBT scores were significantly related to mortality during hospitalization. At 3-month follow-up, only male sex, older age, and higher SBT scores were associated with mortality. Conclusion: We found that the prescription of antipsychotic drugs during hospitalization was not associated with in-hospital or follow-up mortality. Short-term antipsychotic prescriptions (for acutely ill patients) may have a different effect than long-term, repeated prescriptions.

AB - Background: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Results: Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score â¥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score <5 (indicative of normal cognition). In-hospital mortality was slightly higher in patients prescribed antipsychotic drugs (14.3% vs 9.4%; P=0.109), but in multivariate analysis only male sex, older age, and higher SBT scores were significantly related to mortality during hospitalization. At 3-month follow-up, only male sex, older age, and higher SBT scores were associated with mortality. Conclusion: We found that the prescription of antipsychotic drugs during hospitalization was not associated with in-hospital or follow-up mortality. Short-term antipsychotic prescriptions (for acutely ill patients) may have a different effect than long-term, repeated prescriptions.

KW - Antipsychotics

KW - Geriatrics and Gerontology

KW - Gerontology

KW - Hospitalization

KW - Mortality

KW - Older persons

KW - Psychiatry and Mental Health

UR - http://hdl.handle.net/10447/245106

UR - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1479-8301

M3 - Article

JO - Psychogeriatrics

JF - Psychogeriatrics

SN - 1346-3500

ER -