Document Detail


Sudden deaths in psychiatric patients.
MedLine Citation:
PMID:  21672496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies using death certificates have indicated an excess of sudden cardiac deaths among users of antipsychotic drugs compared to the general population, but they may have underestimated the presence of other known causes of sudden and unexpected death.
OBJECTIVE: To assess the causes and risk factors for sudden death discovered by contemporaneous investigation of all deaths occurring over a 26-year period (1984-2009) in adults (119,500 patient-years) receiving care in one large psychiatric hospital in New York.
METHOD: Circumstances of death, psychiatric diagnoses, psychotropic drugs, and past medical history were extracted from the root cause analyses of sudden, unexpected deaths. After cases involving suicide, homicide, and drug overdoses were excluded, the remaining explained and unexplained cases of sudden death were compared regarding clinical variables and the utilization of antipsychotics.
RESULTS: One hundred cases of sudden death were identified. The death remained unexplained in 52 cases. The incidence of unexplained sudden death per 100,000 patient-years increased from 7 (95% CI, 3.7-19.4) in 1984-1998 to 125 (95% CI, 88.9-175.1) in 2005-2009. Explained and unexplained cases were similar regarding psychiatric diagnoses and use of all psychotropic classes, including first- and second-generation antipsychotics. Dyslipidemia (P = .012), diabetes (P = .054), and comorbid dyslipidemia and diabetes (P = .006) were more common in the unexplained group.
CONCLUSIONS: In a consecutive cohort of psychiatric patients, the unexplained sudden deaths were not associated with higher utilization of first- or second-generation antipsychotics. The role of diabetes and dyslipidemia as risk factors for sudden death in psychiatric patients requires careful longitudinal studies.
Authors:
Peter Manu; John M Kane; Christoph U Correll
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-05-03
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  72     ISSN:  1555-2101     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-08-09     Completed Date:  2011-09-30     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  936-41     Citation Subset:  IM    
Copyright Information:
© Copyright 2011 Physicians Postgraduate Press, Inc.
Affiliation:
Medical Services, Zucker Hillside Hospital, 75-59 263rd St, Glen Oaks, NY 11004, USA. pmanu@lij.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / mortality
Adult
Aged
Airway Obstruction / mortality
Antipsychotic Agents / adverse effects*,  therapeutic use
Cause of Death*
Cohort Studies
Comorbidity
Cross-Sectional Studies
Death, Sudden / epidemiology*,  etiology*
Female
Hospitals, Psychiatric / statistics & numerical data
Humans
Intracranial Thrombosis / mortality
Male
Middle Aged
New York City
Pulmonary Embolism / mortality
Retrospective Studies
Risk Factors
Schizophrenia / drug therapy*,  mortality*
Young Adult
Grant Support
ID/Acronym/Agency:
MH 074543-01/MH/NIMH NIH HHS; P30 MH074543-01/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Antipsychotic Agents
Comments/Corrections
Comment In:
Evid Based Ment Health. 2012 May;15(2):30   [PMID:  22228802 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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