Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit
2024

Antipsychotic Medications and Respiratory Failure Risk

Sample size: 638 publication Evidence: moderate

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)

10.1192/bjo.2024.773

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