Antipsychotic Medications and Respiratory Failure Risk
Author Information
Author(s): Sara Winter, Tara Kirkpatrick, Karl Winckel, Faraz Honarparvar, Lewis Robinson, Timothy Tanzer, Lesley Smith, Nicola Warren, Dan Siskind, Claire Michelle Ellender
Primary Institution: Faculty of Medicine, University of Queensland, Brisbane, Australia
Hypothesis
People prescribed antipsychotics would be more prevalent in the HDU cohort, and that antipsychotic use would be associated with poorer outcomes including a longer HDU length of stay, longer hospitalisation and more frequent 30-day readmission rates.
Conclusion
Poor respiratory outcomes may be a previously unknown adverse drug reaction of antipsychotics.
Supporting Evidence
- Antipsychotic medications increased the risk of admission for type 2 respiratory failure by 3.7 times.
- Antipsychotic use increased the risk of requiring non-invasive ventilation by 4.9 times.
- Over 30% of individuals were prescribed antipsychotics for an unlicensed indication.
Takeaway
This study found that people taking antipsychotic medications are more likely to have serious breathing problems when they are admitted to the hospital.
Methodology
Data were collected from medical records for a consecutive sample of individuals admitted to a respiratory HDU between January 2018 and May 2021.
Potential Biases
Potential biases include reliance on clinical coding for data quality and lack of independent verification of psychiatric diagnoses.
Limitations
The study design was retrospective and non-randomised, which may have introduced baseline differences between groups.
Participant Demographics
The cohort included 638 individuals, with 8.5% having a history of serious mental illness.
Statistical Information
P-Value
<0.001
Confidence Interval
95% CI 1.61–8.46 for type 2 respiratory failure; 95% CI 2.42–54.22 for COPD exacerbation without hypercapnia.
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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