6533b83afe1ef96bd12a75c1

RESEARCH PRODUCT

Antipsychotic prescription and mortality in hospitalized older persons

Chiesa DeborahMarengoni AlessandraNobili AlessandroTettamanti MauroPasina LucaFranchi CarlottaD Djade CodjoCorrao SalvatoreSalerno FrancescoMarcucci MauraRomanelli Giuseppe Pier Mannuccio MannucciPrisco DomenicoSilvestri ElenaCenci CaterinaBarnini TommasoDelitala GiuseppeCarta StefanoAtzori SebastianaGuarnieri GianfrancoZanetti MichelaSpalluti Annalisa Maria Grazia Serra Maria Antonietta BleveVanoli MassimoGrignani GiuliaCasella GianlucaGasbarrone LauraManiscalco GiorgioGunelli MassimoTirotta DanielaBrucato AntonioGhidoni Silvia Paola Di CoratoBernardi Mauro Silvia Li BassiSanti LucaAgnelli GiancarloMarchesini EmanuelaMannarino ElmoLupattelli GrazianaRondelli PamelaPaciullo FrancescoFabris FabrizioCarlon MichelaTuratto Francesca Maria Cristina BaroniZardo MariannaRoberto ManfrediniMolino ChristianPala MarcoFabio FabbianNuti RanuccioValenti RobertoRuvio MartinaCappelli SilviaPaolisso Giuseppe Maria Rosaria Rizzo Maria Teresa LaietaSalvatore Teresa Ferdinando Carlo SassoUtili Riccardo Emanuele Durante MangoniPinto DanielaOlivieri Oliviero Anna Maria StanzialRenato FellinStefano VolpatoFotini SioulisBarbagallo MarioDominguez LigiaPlances LidiaD’angelo DanielaRini GiovanbattistaMansueto PasqualePepe IleniaLicata GiuseppeCalvo LuigiValenti MariaBorghi ClaudioStrocchi Enrico Elisa Rebecca RinaldiZoli MarcoFabbri ElisaMagalotti DonatellaAuteri Alberto Anna Laura PasquiPuccetti Luca Franco Laghi Pasini Pier Leopoldo CapecchiBicchi MaurizioSabbà Carlo Francesco Saverio VellaMarseglia Alessandro Chiara Valentina LuglioPalasciano Giuseppe Maria Ester ModeoAquilino AnnamariaRaffaele PallantePugliese StefaniaCapobianco CaterinaPostiglione Alfredo Maria Rosaria Barbella Francesco De StefanoFenoglio LuigiBrignone ChiaraBracco ChristianGiraudo AlessiaMusca GiuseppeCuccurullo OlgaCricco LuigiFiorentini Alessandra Maria Domenica CappelliniFabio GiovannaSeghezzi Sonia Margherita Migone De AmicisFargion SilviaBonara PaolaBulgheroni MaraLombardi RosaPorzio MariannaPeriti GiuliaMagrini FabioMassari FerdinandoTonella TatianaPeyvandi FloraTedeschi AlbertoRossio RaffaellaMoreo GuidoFerrari BarbaraRoncari LuisaMonzani ValterSavojardo ValeriaFolli ChristianMagnini MariaMari Daniela Paolo Dionigi RossiDamanti SarahProlo Silvia Maria Sole LilleriCricco LuigiFiorentini AlessandraMicale GiulianaPodda MauroSelmi CarloMeda FrancescaSalerno FrancescoAccordino SilviaConca AlessioMonti Valentina Gino Roberto CorazzaMiceli Emanuela Marco Vincenzo LentiPadula DonatellaCarlo L. BalduiniBertolino GiampieraProvini StellaQuaglia FedericaMurialdo GiovanniBovio MartaDallegri FrancoOttonello LucianoQuercioli AlessandraBarreca Alessandra Maria Beatrice SecchiGhelfi Davide Wu Sheng ChinCarassale LauraCaporotundo SilviaAnastasio LuigiSofia LuciaCarbone MariaTraisci Giancarlo Lucrezia De Feudis Silvia Di CarloDavì Giovanni Maria Teresa GuagnanoSestili SimonaBergami ElisabettaRizzioli EmanuelaCagnoni CarloBertone LucaManucra AntonioBuratti AlbertoTognin Tiziana Nicola Lucio LiberatoBernasconi GiordanoNardo Barbara Giovanni Battista BianchiGiaquinto SabrinaBenetti GiampieroQuagliolo Michela Giuseppe Riccardo CentenaroPurrello Francesco Antonino Di PinoPiro SalvatoreMancuso GerardoCalipari DanielaBartone MosèGullo FrancescoCortellaro MicheleMagenta MarinaPerego Francesca Maria Rachele MeroniCicardi Marco Antonio Gidaro Marina MagentaSacco AndreaBonelli AntonioDentamaro GaetanoRozzini RenzoFalanga LinaGiordano Alessandro Paolo Cavallo PerinLorenzati BartolomeoGruden GabriellaBruno GraziellaMontrucchio GiuseppeGreco ElisabettaTizzani PietroFera Giacomo Maria Loreta Di LucaRenna DonatellaPerciccante AntonioCoralli AlessiaTassara RodolfoMelis DeborahRebella LaraMenardo GiorgioBottone StefaniaSferrazzo ElsaFerri ClaudioStriuli RinaldoScipioni RosaSalmi RaffaellaGaudenzi PiergiorgioGamberini SusannaRicci FrancoMorabito CosimoFava RobertoSemplicini AndreaGottardo LuciaVendemiale GianluigiServiddio GaetanoForlano RobertaBolondi LuigiRasciti LeonardoSerio IlariaMasala CesareMammarella AntonioValeria Raparelli Filippo Rossi FanelliDelfino MassimoAmoroso AntonioVioli FrancescoBasili StefaniaPerri LudovicaSerra PietroFontana VincenzoFalcone MarcoLandolfi RaffaeleGrieco AntonioGallo AntonellaZuccalà GiuseppeFranceschi Francesco Guido De MarcoChiara CordischiMarta SabbatiniBellusci MartinoSetti DonatellaPedrazzoli FilippoRomanelli GiuseppePirali CaterinaAmolini Claudia Enrico Agabiti RoseiRizzoni DamianoCastoldi LuanaPicardi Antonio Umberto Vespasiani GentilucciMazzarelli ChiaraGallo PaoloGuasti LuiginaCastiglioni LuanaMaresca AndreaSquizzato AlessandroContini SaraMolaro MartaAnnoni GiorgioCorsi MaurizioZazzetta SaraBertolotti MarcoMussi ChiaraScotto Roberto Maria Alice FerriVeltri FrancescaArturi FrancoSuccurro ElenaSesti GiorgioGualtieri UmbertoPerticone FrancescoSciacqua AngelaQuero MicheleBagnato ChiaraLoria Paola Maria Angela BecchiMartucci GianfrancoFantuzzi AlessandraMaurantonio MauroCorinaldesi RobertoRoberto De GiorgioSerra MauroGrasso ValentinaRuggeri Eugenio Lorenzo Mauro CarozzaPignatti. Fabio

subject

MaleSocio-culturaleOlder personAntipsychoticCognitionEconomicaAntipsychotics; Hospitalization; Mortality; Older persons; Gerontology; Geriatrics and Gerontology; Psychiatry and Mental HealthHumansMortalityPsychomotor AgitationAgedantipsychotics hospitalization mortality older personsAged 80 and overMental DisordersPatient DischargeHospitalizationantipsychoticsItalyantipsychotics; hospitalization; mortality; older personsPsychiatry and Mental Healtholder personsDementiaFemaleGeriatrics and GerontologyGerontologyAntipsychotic Agents

description

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 ≥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.

yearjournalcountryeditionlanguage
2016-06-07
10.1111/psyg.12263http://hdl.handle.net/10447/245106