title: Proton pump inhibitors and risk of 1-year mortality and rehospitalization in older patients discharged from acute care hospitals.
abstract: OBJECTIVE
  The use of proton pump inhibitors (PPIs) has rapidly increased during the past several years. However, concern remains about risks associated with their long-term use in older populations.
  
  
  OBJECTIVE
  To investigate the relationship between the use of PPIs and the risk of death or the combined end point of death or rehospitalization in older patients discharged from acute care hospitals.
  
  
  METHODS
  We investigated the relationship between PPI use and study outcomes using time-dependent Cox proportional hazards regression in patients 65 years or older discharged from acute care medical wards from April 1 to June 30, 2007.
  
  
  METHODS
  Eleven acute care medical wards.
  
  
  METHODS
  Four hundred ninety-one patients (mean [SD] age, 80.0 [5.9] years).
  
  
  METHODS
  Mortality and the combined end point of death or rehospitalization. RESULTS The use of PPIs was independently associated with mortality (hazard ratio, 1.51 [95% CI, 1.03-2.77]) but not with the combined end point (1.49 [0.98-2.17]). An increased risk of mortality was observed among patients exposed to high-dose PPIs vs none (hazard ratio, 2.59 [95% CI, 1.22-7.16]).
  
  
  CONCLUSIONS
  In older patients discharged from acute care hospitals, the use of high-dose PPIs is associated with increased 1-year mortality. Randomized controlled studies including older frail patients are needed. In the meantime, physicians need to use caution and balance benefits and harms in long-term prescription of high-dose PPIs.
authors: Department of Geriatric Rehabilitation, University-Hospital of Parma, Parma, Italy. marcellomaggio2001@yahoo.it
authors: Marcello
authors: M
authors: Maggio
authors: Andrea
authors: A
authors: Corsonello
authors: Gian Paolo
authors: GP
authors: Ceda
authors: Chiara
authors: C
authors: Cattabiani
authors: Fulvio
authors: F
authors: Lauretani
authors: Valeria
authors: V
authors: Buttò
authors: Luigi
authors: L
authors: Ferrucci
authors: Stefania
authors: S
authors: Bandinelli
authors: Angela Marie
authors: AM
authors: Abbatecola
authors: Liana
authors: L
authors: Spazzafumo
authors: Fabrizia
authors: F
authors: Lattanzio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality; D010359:Patient Readmission; D016016:Proportional Hazards Models; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012306:Risk; D013997:Time Factors
chemical_list: D054328:Proton Pump Inhibitors