(P-359) Assessment of Antipsychotic Use and Other Predictors Associated with Mortality in Patients with Delirium: A Population-based Nested Case Control Study

Location: Poster Gallery-Drug Effectiveness

Presenting Author(s)

HT

Hsiang-Te Tsai

NCKU Institute of Clinical Pharmacy and Pharmaceutical Sciences
Tainan, Tainan, Taiwan

Co-Author(s)

WC

Wei-Hung Chang

Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan, Tainan, Taiwan (Republic of China)
EL

Edward Chia-Cheng Lai

Associate Professor
School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Tainan, Taiwan (Republic of China)

Background: Antipsychotics may provide benefits for the control of psychotic symptoms in patients with delirium. Understanding of mortality risk profiles among different antipsychotics is important for selecting appropriate treatment.

Objectives: To evaluate the risk of mortality in patients with delirium receiving antipsychotics and the associated risk factors.

Methods: We performed a nested case-control study using National Health Insurance Database (NHID). We included patients with delirium receiving antipsychotics between 2002 and 2013. We excluded patients with psychiatry disorders including schizophrenia, depression, bipolar disorder to avoid misclassification of delirium diagnosis. Cases were defined as patients who died within 180 days; otherwise patients were considered as controls. We compared patients’ antipsychotics and other covariates such as age, sex and alcohol and drug abuse etc. between two groups. The odds ratios (OR) and 95% CI were derived from multi-variable logistic regression models.

Results: We identified a total of 4,086 patients with delirium receiving antipsychotics in this study. The mean age of patients was 67.7 (SD 19.3) years old and 2,526 (61.8%) of them were male. There were 448 (11%) case patients and 3,638 (89%) controls. We found patients receiving risperidone (OR 1.49, 95% CI 1.08-2.05) and quetiapine (OR 1.37, 95% CI 1.07-1.74) were associated with increased risk of mortality. Specifically, patients with a record of alcohol and drug abuse were associated with increased risk of mortality (OR 2.45, 95% CI 1.36-4.44).

Conclusions: The finding warrants attention that risperidone and quetiapine use and patients with alcohol and drug abuse may associate with increased mortality risk.