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

<h4>Background and purpose</h4>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.<h4>Methods</h4>...

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Autores principales:	Anders Prior, Thomas Munk Laursen, Karen Kjær Larsen, Søren Paaske Johnsen, Jakob Christensen, Grethe Andersen, Mogens Vestergaard
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a7d7d9d578c04e5995bbeb045466cd04
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spelling	oai:doaj.org-article:a7d7d9d578c04e5995bbeb045466cd042021-11-18T08:38:37ZPost-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.1932-620310.1371/journal.pone.0084103https://doaj.org/article/a7d7d9d578c04e5995bbeb045466cd042014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24416196/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and purpose</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.Anders PriorThomas Munk LaursenKaren Kjær LarsenSøren Paaske JohnsenJakob ChristensenGrethe AndersenMogens VestergaardPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e84103 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Anders Prior Thomas Munk Laursen Karen Kjær Larsen Søren Paaske Johnsen Jakob Christensen Grethe Andersen Mogens Vestergaard Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.
description	<h4>Background and purpose</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.
format	article
author	Anders Prior Thomas Munk Laursen Karen Kjær Larsen Søren Paaske Johnsen Jakob Christensen Grethe Andersen Mogens Vestergaard
author_facet	Anders Prior Thomas Munk Laursen Karen Kjær Larsen Søren Paaske Johnsen Jakob Christensen Grethe Andersen Mogens Vestergaard
author_sort	Anders Prior
title	Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.
title_short	Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.
title_full	Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.
title_fullStr	Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.
title_full_unstemmed	Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.
title_sort	post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/a7d7d9d578c04e5995bbeb045466cd04
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Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.

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