- Atypical antipsychotic use (vs nonuse) is associated with 20% higher mortality in older adults ≥65 years hospitalized for pneumonia.
Why this matters
- Clinicians should minimize prescribing of atypical antipsychotics in older patients, as well as closely monitor patients who are prescribed atypical antipsychotics regardless of reason.
- Retrospective cohort of 102,897 patients in the Department of Veterans Affairs Health Care System during a 10-year period.
- Propensity-matched comparison of 5513 users vs 5513 nonusers of atypical antipsychotics.
- Funding: National Institute of Nursing Research.
- Use of atypical antipsychotics was associated with increased likelihood of 30-day pneumonia mortality (OR, 1.20; 95% CI, 1.11-1.31) and 90-day pneumonia mortality (OR, 1.19; 95% CI, 1.09-1.30).
- Secondary analysis found that 90-day pneumonia mortality among users of antipsychotics was increased across:
- The entire cohort (OR, 1.31; 95% CI, 1.22-1.40).
- Psychiatric patients (OR, 1.21; 95% CI, 1.12-1.30).
- Preexisting cardiac conditions (OR, 1.22; 95% CI, 1.09-1.36).
- Secondary analysis did not find increased pneumonia mortality among older adults prescribed atypical antipsychotics for dementia (OR, 0.96; 95% CI, 0.82-1.12).
- Observational design.
- Older adults in VA hospitals may not be representative of all older adults.