Population-based cohort study on the risk of pneumonia in patients with non-traumatic intracranial haemorrhage who use proton pump inhibitors.
OBJECTIVE
This nationwide cohort study investigated the association between proton pump inhibitor (PPI) usage and the risk of pneumonia in patients with non-traumatic intracranial haemorrhage (ICH).


METHODS
Nationwide population-based cohort study.


METHODS
Longitudinal Health Insurance Database 2010 (LHID2010) sampled from the Taiwan National Health Insurance Research Database.


METHODS
4644 patients with non-traumatic ICH from 2010 to 2011 were identified. Patients aged <18 years and newly diagnosed with non-traumatic ICH complicated with pneumonia during the same admission period were excluded. A total of 2170 participants were eligible for the final analysis.


METHODS
Patients using PPIs or not during the study period were tracked to identify the occurrence of any type of pneumonia.


RESULTS
The adjusted HR of the risk of pneumonia for ICH patients who used PPIs was 1.61 (95% CI 1.32 to 1.97, p<0.001). The risk of pneumonia was positively associated with the administration of PPIs. We observed a greater risk of pneumonia in patients who used PPIs than in those who did not. Moreover, we observed that the risk of pneumonia in patients who used PPIs was 2.60 and 2.04 (95% CI 2.01 to 3.38, p<0.001; 95% CI 1.34 to 3.10, p<0.001) greater than that in patients who did not use PPIs when the defined daily dose was <30 and 30-60, respectively.


CONCLUSIONS
The results of this study indicate that the use of PPIs in patients with non-traumatic ICH is associated with an increased risk of pneumonia, and the severity of this risk depends on the defined daily dose. Physicians should exercise caution when prescribing PPIs for patients with non-traumatic ICH.
Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
Sai-Wai
SW
Ho
Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
Ming-Che
MC
Tsai
Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
Ying-Hock
YH
Teng
School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.
Ying-Tung
YT
Yeh
Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
Yu-Hsun
YH
Wang
Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Shun-Fa
SF
Yang
Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
Chao-Bin
CB
Yeh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced* / Q000453:epidemiology; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult
D054328:Proton Pump Inhibitors
INFECTIOUS DISEASES