Cardiac complications associated with short-term mortality in schizophrenia patients hospitalized for pneumonia: a nationwide case-control study
Pneumonia is one of most prevalent infectious diseases worldwide and is associated with considerable mortality. In comparison to general population, schizophrenia patients hospitalized for pneumonia have poorer outcomes. We explored the risk factors of short-term mortality in this population because...
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| Veröffentlicht in: | PloS one 2013-07, Vol.8 (7), p.e70142-e70142 |
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| creator | Liao, Ya-Tang Yang, Shu-Yu Liu, Hsing-Cheng Chen, Wei J Chen, Chiao-Chicy Hung, Yen-Ni Kuo, Chian-Jue |
| description | Pneumonia is one of most prevalent infectious diseases worldwide and is associated with considerable mortality. In comparison to general population, schizophrenia patients hospitalized for pneumonia have poorer outcomes. We explored the risk factors of short-term mortality in this population because the information is lacking in the literature.
In a nationwide schizophrenia cohort, derived from the National Health Insurance Research Database in Taiwan, that was hospitalized for pneumonia between 2000 and 2008 (n = 1,741), we identified 141 subjects who died during their hospitalizations or shortly after their discharges. Based on risk-set sampling in a 1∶4 ratio, 468 matched controls were selected from the study cohort (i.e., schizophrenia cohort with pneumonia). Physical illnesses were categorized as pre-existing and incident illnesses that developed after pneumonia respectively. Exposures to medications were categorized by type, duration, and defined daily dose. We used stepwise conditional logistic regression to explore the risk factors for short-term mortality.
Pre-existing arrhythmia was associated with short-term mortality (adjusted risk ratio [RR] = 4.99, p |
| doi_str_mv | 10.1371/journal.pone.0070142 |
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In a nationwide schizophrenia cohort, derived from the National Health Insurance Research Database in Taiwan, that was hospitalized for pneumonia between 2000 and 2008 (n = 1,741), we identified 141 subjects who died during their hospitalizations or shortly after their discharges. Based on risk-set sampling in a 1∶4 ratio, 468 matched controls were selected from the study cohort (i.e., schizophrenia cohort with pneumonia). Physical illnesses were categorized as pre-existing and incident illnesses that developed after pneumonia respectively. Exposures to medications were categorized by type, duration, and defined daily dose. We used stepwise conditional logistic regression to explore the risk factors for short-term mortality.
Pre-existing arrhythmia was associated with short-term mortality (adjusted risk ratio [RR] = 4.99, p<0.01). Several variables during hospitalization were associated with increased mortality risk, including incident arrhythmia (RR = 7.44, p<0.01), incident heart failure (RR = 5.49, p = 0.0183) and the use of hypoglycemic drugs (RR = 2.32, p<0.01). Furthermore, individual antipsychotic drugs (such as clozapine) known to induce pneumonia were not significantly associated with the risk.
Incident cardiac complications following pneumonia are associated with increased short-term mortality. These findings have broad implications for clinical intervention and future studies are needed to clarify the mechanisms of the risk factors.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0070142</identifier><identifier>PMID: 23922940</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Antipsychotics ; Arrhythmia ; Biology ; Cardiac arrhythmia ; Case-Control Studies ; Clozapine ; Comorbidity ; Complications ; Confidentiality ; Diabetes ; Drugs ; Epidemiology ; Female ; Health care ; Heart ; Heart diseases ; Heart Diseases - epidemiology ; Heart Diseases - etiology ; Heart Diseases - mortality ; Hospitalization ; Hospitals ; Humans ; Hyperglycemia ; Hypoglycemia ; Illnesses ; Incidence ; Infectious diseases ; Male ; Medicine ; Mental disorders ; Middle Aged ; Mortality ; Nursing ; Older people ; Patients ; Pharmacy ; Pneumonia ; Pneumonia - complications ; Pneumonia - drug therapy ; Population ; Prevalence ; Preventive medicine ; Psychiatry ; Psychotropic drugs ; Public health ; Risk analysis ; Risk Factors ; Schizophrenia ; Schizophrenia - complications ; Schizophrenia - drug therapy ; Short term ; Studies ; Systematic review</subject><ispartof>PloS one, 2013-07, Vol.8 (7), p.e70142-e70142</ispartof><rights>2013 Liao et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Liao et al 2013 Liao et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-96578c952a85a8b100b9927a7e2e7471a50bda6db18e18c69f0e734dd72661cc3</citedby><cites>FETCH-LOGICAL-c526t-96578c952a85a8b100b9927a7e2e7471a50bda6db18e18c69f0e734dd72661cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726532/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726532/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23865,27923,27924,53790,53792,79371,79372</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23922940$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Zhou, Dongsheng</contributor><creatorcontrib>Liao, Ya-Tang</creatorcontrib><creatorcontrib>Yang, Shu-Yu</creatorcontrib><creatorcontrib>Liu, Hsing-Cheng</creatorcontrib><creatorcontrib>Chen, Wei J</creatorcontrib><creatorcontrib>Chen, Chiao-Chicy</creatorcontrib><creatorcontrib>Hung, Yen-Ni</creatorcontrib><creatorcontrib>Kuo, Chian-Jue</creatorcontrib><title>Cardiac complications associated with short-term mortality in schizophrenia patients hospitalized for pneumonia: a nationwide case-control study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Pneumonia is one of most prevalent infectious diseases worldwide and is associated with considerable mortality. In comparison to general population, schizophrenia patients hospitalized for pneumonia have poorer outcomes. We explored the risk factors of short-term mortality in this population because the information is lacking in the literature.
In a nationwide schizophrenia cohort, derived from the National Health Insurance Research Database in Taiwan, that was hospitalized for pneumonia between 2000 and 2008 (n = 1,741), we identified 141 subjects who died during their hospitalizations or shortly after their discharges. Based on risk-set sampling in a 1∶4 ratio, 468 matched controls were selected from the study cohort (i.e., schizophrenia cohort with pneumonia). Physical illnesses were categorized as pre-existing and incident illnesses that developed after pneumonia respectively. Exposures to medications were categorized by type, duration, and defined daily dose. We used stepwise conditional logistic regression to explore the risk factors for short-term mortality.
Pre-existing arrhythmia was associated with short-term mortality (adjusted risk ratio [RR] = 4.99, p<0.01). Several variables during hospitalization were associated with increased mortality risk, including incident arrhythmia (RR = 7.44, p<0.01), incident heart failure (RR = 5.49, p = 0.0183) and the use of hypoglycemic drugs (RR = 2.32, p<0.01). Furthermore, individual antipsychotic drugs (such as clozapine) known to induce pneumonia were not significantly associated with the risk.
Incident cardiac complications following pneumonia are associated with increased short-term mortality. These findings have broad implications for clinical intervention and future studies are needed to clarify the mechanisms of the risk factors.</description><subject>Adult</subject><subject>Antipsychotics</subject><subject>Arrhythmia</subject><subject>Biology</subject><subject>Cardiac arrhythmia</subject><subject>Case-Control Studies</subject><subject>Clozapine</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Confidentiality</subject><subject>Diabetes</subject><subject>Drugs</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health care</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart Diseases - epidemiology</subject><subject>Heart Diseases - etiology</subject><subject>Heart Diseases - mortality</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hypoglycemia</subject><subject>Illnesses</subject><subject>Incidence</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medicine</subject><subject>Mental disorders</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nursing</subject><subject>Older people</subject><subject>Patients</subject><subject>Pharmacy</subject><subject>Pneumonia</subject><subject>Pneumonia - complications</subject><subject>Pneumonia - drug therapy</subject><subject>Population</subject><subject>Prevalence</subject><subject>Preventive medicine</subject><subject>Psychiatry</subject><subject>Psychotropic drugs</subject><subject>Public health</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Schizophrenia</subject><subject>Schizophrenia - complications</subject><subject>Schizophrenia - drug therapy</subject><subject>Short term</subject><subject>Studies</subject><subject>Systematic review</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1v1DAQjRCIloV_gMASFy5Z_BU75oCEVgUqVeICZ2tiO41XSRxsp9X2V_CTm-1uqxZx8sjz3ps3o1cUbwleEybJp22Y4wj9egqjW2MsMeH0WXFKFKOloJg9f1SfFK9S2mJcsVqIl8UJZYpSxfFp8XcD0XowyIRh6r2B7MOYEKQUjIfsLLr2uUOpCzGX2cUBDUsFvc875EeUTOdvwtRFN3pA08J2Y06oC2nye9TNItCGiKbRzUNYMJ8RoPFuyLW3DhlIrjRhzDH0KOXZ7l4XL1rok3tzfFfF729nvzY_youf3883Xy9KU1GRSyUqWRtVUagrqBuCcaMUlSAddZJLAhVuLAjbkNqR2gjVYicZt1ZSIYgxbFW8P-hOfUj6eMykCedYKaFkvSDODwgbYKun6AeIOx3A67uPEC81xOxN7zRreNvUSkpVG044KA51q7BtibGSLYNXxZfjtLkZnDXLlSL0T0Sfdkbf6ctwpdnit2J0Efh4FIjhz-xS1oNPxvU9jC7Me9-kFrxSbO_7wz_Q_2_HDygTQ0rRtQ9mCNb7gN2z9D5g-hiwhfbu8SIPpPtEsVtartL5</recordid><startdate>20130729</startdate><enddate>20130729</enddate><creator>Liao, Ya-Tang</creator><creator>Yang, Shu-Yu</creator><creator>Liu, Hsing-Cheng</creator><creator>Chen, Wei J</creator><creator>Chen, Chiao-Chicy</creator><creator>Hung, Yen-Ni</creator><creator>Kuo, Chian-Jue</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130729</creationdate><title>Cardiac complications associated with short-term mortality in schizophrenia patients hospitalized for pneumonia: a nationwide case-control study</title><author>Liao, Ya-Tang ; Yang, Shu-Yu ; Liu, Hsing-Cheng ; Chen, Wei J ; Chen, Chiao-Chicy ; Hung, Yen-Ni ; Kuo, Chian-Jue</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-96578c952a85a8b100b9927a7e2e7471a50bda6db18e18c69f0e734dd72661cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Antipsychotics</topic><topic>Arrhythmia</topic><topic>Biology</topic><topic>Cardiac arrhythmia</topic><topic>Case-Control Studies</topic><topic>Clozapine</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Confidentiality</topic><topic>Diabetes</topic><topic>Drugs</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Health care</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Heart Diseases - epidemiology</topic><topic>Heart Diseases - etiology</topic><topic>Heart Diseases - mortality</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hypoglycemia</topic><topic>Illnesses</topic><topic>Incidence</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medicine</topic><topic>Mental disorders</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nursing</topic><topic>Older people</topic><topic>Patients</topic><topic>Pharmacy</topic><topic>Pneumonia</topic><topic>Pneumonia - complications</topic><topic>Pneumonia - drug therapy</topic><topic>Population</topic><topic>Prevalence</topic><topic>Preventive medicine</topic><topic>Psychiatry</topic><topic>Psychotropic drugs</topic><topic>Public health</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Schizophrenia</topic><topic>Schizophrenia - complications</topic><topic>Schizophrenia - drug therapy</topic><topic>Short term</topic><topic>Studies</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liao, Ya-Tang</creatorcontrib><creatorcontrib>Yang, Shu-Yu</creatorcontrib><creatorcontrib>Liu, Hsing-Cheng</creatorcontrib><creatorcontrib>Chen, Wei J</creatorcontrib><creatorcontrib>Chen, Chiao-Chicy</creatorcontrib><creatorcontrib>Hung, Yen-Ni</creatorcontrib><creatorcontrib>Kuo, Chian-Jue</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liao, Ya-Tang</au><au>Yang, Shu-Yu</au><au>Liu, Hsing-Cheng</au><au>Chen, Wei J</au><au>Chen, Chiao-Chicy</au><au>Hung, Yen-Ni</au><au>Kuo, Chian-Jue</au><au>Zhou, Dongsheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac complications associated with short-term mortality in schizophrenia patients hospitalized for pneumonia: a nationwide case-control study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-07-29</date><risdate>2013</risdate><volume>8</volume><issue>7</issue><spage>e70142</spage><epage>e70142</epage><pages>e70142-e70142</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Pneumonia is one of most prevalent infectious diseases worldwide and is associated with considerable mortality. In comparison to general population, schizophrenia patients hospitalized for pneumonia have poorer outcomes. We explored the risk factors of short-term mortality in this population because the information is lacking in the literature.
In a nationwide schizophrenia cohort, derived from the National Health Insurance Research Database in Taiwan, that was hospitalized for pneumonia between 2000 and 2008 (n = 1,741), we identified 141 subjects who died during their hospitalizations or shortly after their discharges. Based on risk-set sampling in a 1∶4 ratio, 468 matched controls were selected from the study cohort (i.e., schizophrenia cohort with pneumonia). Physical illnesses were categorized as pre-existing and incident illnesses that developed after pneumonia respectively. Exposures to medications were categorized by type, duration, and defined daily dose. We used stepwise conditional logistic regression to explore the risk factors for short-term mortality.
Pre-existing arrhythmia was associated with short-term mortality (adjusted risk ratio [RR] = 4.99, p<0.01). Several variables during hospitalization were associated with increased mortality risk, including incident arrhythmia (RR = 7.44, p<0.01), incident heart failure (RR = 5.49, p = 0.0183) and the use of hypoglycemic drugs (RR = 2.32, p<0.01). Furthermore, individual antipsychotic drugs (such as clozapine) known to induce pneumonia were not significantly associated with the risk.
Incident cardiac complications following pneumonia are associated with increased short-term mortality. These findings have broad implications for clinical intervention and future studies are needed to clarify the mechanisms of the risk factors.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23922940</pmid><doi>10.1371/journal.pone.0070142</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Antipsychotics Arrhythmia Biology Cardiac arrhythmia Case-Control Studies Clozapine Comorbidity Complications Confidentiality Diabetes Drugs Epidemiology Female Health care Heart Heart diseases Heart Diseases - epidemiology Heart Diseases - etiology Heart Diseases - mortality Hospitalization Hospitals Humans Hyperglycemia Hypoglycemia Illnesses Incidence Infectious diseases Male Medicine Mental disorders Middle Aged Mortality Nursing Older people Patients Pharmacy Pneumonia Pneumonia - complications Pneumonia - drug therapy Population Prevalence Preventive medicine Psychiatry Psychotropic drugs Public health Risk analysis Risk Factors Schizophrenia Schizophrenia - complications Schizophrenia - drug therapy Short term Studies Systematic review |
| title | Cardiac complications associated with short-term mortality in schizophrenia patients hospitalized for pneumonia: a nationwide case-control study |
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