Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
PLoS One. 2014 Jan 8;9(1):e84103. doi: 10.1371/journal.pone.0084103. eCollection 2014.

Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.

Author information

  • 1Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark ; Section for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
  • 2National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
  • 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
  • 4Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.

Abstract

BACKGROUND AND PURPOSE:

It has been suggested that antipsychotic medication may be neuroprotective and may reduce post-stroke mortality, but studies are few and ambiguous. We aimed to investigate the post-stroke effects of preadmission antipsychotic use.

METHODS:

We conducted a nationwide, population-based cohort study of 81,143 persons admitted with stroke in Denmark from 2003-2010. Using Danish health care databases, we extracted data on preadmission use of antipsychotics and confounding factors. We examined the association between current, former, and never use of antipsychotics and stroke severity, length of hospital stay, and 30-day post-stroke mortality using logistic regression analysis, survival analysis, and propensity score matching.

RESULTS:

Current users of antipsychotics had a higher risk of severe or very severe stroke on The Scandinavian Stroke Scale than never users of antipsychotics (adjusted odds ratios, 1.43; 95% CI, 1.29-1.58). Current users were less likely to be discharged from hospital within 30 days of admission than never users (probability of non-discharge, 27.0% vs. 21.9%). Antipsychotics was associated with an increased 30-day post-stroke mortality among current users (adjusted mortality rate ratios, 1.42; 95% CI, 1.29-1.55), but not among former users (adjusted mortality rate ratios, 1.05; 95% CI, 0.98-1.14).

CONCLUSIONS:

Preadmission use of antipsychotics was associated with a higher risk of severe stroke, a longer duration of hospital stay, and a higher post-stroke mortality, even after adjustment for known confounders. Antipsychotics play an important role in the treatment of many psychiatric conditions, but our findings do not support the hypothesis that they reduce stroke severity or post-stroke mortality.

PMID:
24416196
[PubMed - indexed for MEDLINE]
PMCID:
PMC3885530
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Public Library of Science Icon for PubMed Central
    Loading ...
    Write to the Help Desk