Use of selective serotonin reuptake inhibitors and risk of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study.
BACKGROUND
Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association.


METHODS
We conducted a population-based study of the risk of re-operation due to post-surgical bleeding within two weeks of primary surgery among Danish women with primary breast cancer. Patients were categorised according to their use of SSRI: never users, current users (SSRI prescription within 30 days of initial breast cancer surgery), and former users (SSRI prescription more than 30 days before initial breast cancer surgery). We calculated the risk of re-operation due to post-surgical bleeding within 14 days of initial surgery, and the relative risk (RR) of re-operation comparing SSRI users with never users of SSRI adjusting for potential confounders.


RESULTS
389 of 14,464 women (2.7%) were re-operated. 1592 (11%) had a history of SSRI use. Risk of re-operation was 2.6% among never users, 7.0% among current SSRI users, and 2.7% among former users. Current users thus had an increased risk of re-operation due to post-operative bleeding (adjusted relative risk = 2.3; 95% confidence interval (CI) = 1.4, 3.9) compared with never users. There was no increased risk of re-operation associated with former use of SSRI (RR = 0.93, 95% CI = 0.66, 1.3).


CONCLUSIONS
Current use of SSRI is associated with an increased risk of re-operation due to bleeding after surgery for breast cancer.
Gärtner
Rune
R
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, Aarhus N 8200, Denmark. rune.gartner@rh.regionh.dk
Cronin-Fenton
Deirdre
D
Hundborg
Heidi H
HH
Pedersen
Lars
L
Lash
Timothy L
TL
Sørensen
Henrik Toft
HT
Kroman
Niels
N
D001792:Blood Platelets / Q000187:drug effects*; D001943:Breast Neoplasms / Q000601:surgery*; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*
D017367:Selective Serotonin Reuptake Inhibitors