Antipsychotic drugs and short-term mortality after peptic ulcer perforation: a population-based cohort study.
BACKGROUND
Peptic ulcer perforation is a serious surgical emergency with a substantial short-term mortality, but the influence of antipsychotic drug use on the prognosis remains unknown.


OBJECTIVE
To examine the association between antipsychotic drug use and 30-day mortality following peptic ulcer perforation.


METHODS
This cohort study comprised 2033 patients with a first-time hospitalization with peptic ulcer perforation, in Northern Denmark, between 1991 and 2004. Data on preadmission use of antipsychotics and other medications, psychiatric disease, other comorbidities and mortality were obtained through population-based medical databases. We used Cox regression analyses to compute adjusted mortality rate ratios (MRRs).


RESULTS
One hundred and sixteen (5.7%) patients with peptic ulcer perforation were current users of antipsychotic drugs at the time of hospital admission and 205 (10.1%) were former users. The overall 30-day mortality was 27%. Among current users of antipsychotics 30-day mortality was 39%. The adjusted 30-day MRR for current users of antipsychotic drugs compared with non-users was 1.7 (95% CI: 1.2-2.3). Former use was not a predictor of mortality. The increase in mortality was equal in users of conventional and atypical antipsychotics.


CONCLUSIONS
Use of antipsychotic drugs is associated with substantially increased mortality following peptic ulcer perforation.
Christiansen
C
C
Department of Clinical Epidemiology, Aarhus University Hospital, University of Aarhus, Aarhus, Dennmark.
Christensen
S
S
Riis
A
A
Thomsen
R W
RW
Johnsen
S P
SP
Tonnesen
E
E
Sorensen
H T
HT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage; D010439:Peptic Ulcer Perforation / Q000401:mortality*; D016016:Proportional Hazards Models
D014150:Antipsychotic Agents