Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation
The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate >= 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardi...
Gespeichert in:
| Veröffentlicht in: | Journal of clinical medicine 2021-04, Vol.10 (7), p.1534, Article 1534 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 7 |
| container_start_page | 1534 |
| container_title | Journal of clinical medicine |
| container_volume | 10 |
| creator | Lim, Andy K. H. Azraai, Meor Pham, Jeanette H. Looi, Wenye F. Wirth, Daniel Ng, Ashley S. L. Babu, Umesh Saluja, Bharat |
| description | The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate >= 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardia in an inpatient population of patients with mental illness, while considering factors which may contribute to tachycardia. We retrospectively analyzed data from 636 Medical Emergency Team (MET) calls occurring in 449 psychiatry inpatients in three metropolitan hospitals co-located with acute medical services, and used mixed-effects logistic regression to model the association between severe tachycardia and antipsychotic use. The median age of patients was 42 years and 39% had a diagnosis of schizophrenia or psychotic disorder. Among patients who experienced MET calls, the use of second-generation (atypical) antipsychotics was commonly encountered (70%), but the use of first-generation (conventional) antipsychotics was less prevalent (10%). Severe tachycardia was noted in 22% of all MET calls, and sinus tachycardia was the commonest cardiac rhythm. After adjusting for age, anticholinergic medication use, temperature >38 degrees C and hypoglycemia, and excluding patients with infection and venous thromboembolism, the odds ratio for severe tachycardia with antipsychotic medication use was 4.09 (95% CI: 1.64 to 10.2). |
| doi_str_mv | 10.3390/jcm10071534 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_webofscience_primary_000638619000001CitationCount</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2641042189</sourcerecordid><originalsourceid>FETCH-LOGICAL-c409t-7536a14356ef8e5337033a0d196c176694e1d20abbc3e3c51af2d3e1c2dd28673</originalsourceid><addsrcrecordid>eNqNkl2LEzEYhQdR3GXdK-8l4I2wVPMxHxkvhFJWd2FFYet1SN-8s02ZmYxJpsv8B3-0qa21emVuEjjPezjJSZa9ZPStEDV9t4GOUVqxQuRPsnNOq2pGhRRPT85n2WUIG5qWlDln1fPsLI2yqmDFefbjHrfokSw1rCfQ3lhN5iE4sDqiIY82rsnXMMHaRe8GC-QzGgs6WtcHYvu9llifpNt-SAL2Mbwnc3IfRzMR15AbFwYbdXsYbcl1h_4Be5jIEnVH5hDt9pfji-xZo9uAl4f9Ivv28Xq5uJndffl0u5jfzSCndZxVhSg1y0VRYiOxEKKiQmhqWF0Cq8qyzpEZTvVqBQIFFEw33AhkwI3hsqzERfZh7zuMqw4NpMhet2rwttN-Uk5b9bfS27V6cFsl03tKzpPBm4OBd99HDFF1NgC2re7RjUHxglNZMs5EQl__g27c6Pt0PcXLnNHUiKwTdbWnwLsQPDbHMIyqXdHqpOhEvzrNf2R_1_rH7hFXrgmQSgE8YuknlCLFq3d_grJEy_-nF6nKXVcLN_ZR_AS_N8YH</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2641042189</pqid></control><display><type>article</type><title>Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><source>Web of Science - Social Sciences Citation Index – 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Lim, Andy K. H. ; Azraai, Meor ; Pham, Jeanette H. ; Looi, Wenye F. ; Wirth, Daniel ; Ng, Ashley S. L. ; Babu, Umesh ; Saluja, Bharat</creator><creatorcontrib>Lim, Andy K. H. ; Azraai, Meor ; Pham, Jeanette H. ; Looi, Wenye F. ; Wirth, Daniel ; Ng, Ashley S. L. ; Babu, Umesh ; Saluja, Bharat</creatorcontrib><description>The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate >= 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardia in an inpatient population of patients with mental illness, while considering factors which may contribute to tachycardia. We retrospectively analyzed data from 636 Medical Emergency Team (MET) calls occurring in 449 psychiatry inpatients in three metropolitan hospitals co-located with acute medical services, and used mixed-effects logistic regression to model the association between severe tachycardia and antipsychotic use. The median age of patients was 42 years and 39% had a diagnosis of schizophrenia or psychotic disorder. Among patients who experienced MET calls, the use of second-generation (atypical) antipsychotics was commonly encountered (70%), but the use of first-generation (conventional) antipsychotics was less prevalent (10%). Severe tachycardia was noted in 22% of all MET calls, and sinus tachycardia was the commonest cardiac rhythm. After adjusting for age, anticholinergic medication use, temperature >38 degrees C and hypoglycemia, and excluding patients with infection and venous thromboembolism, the odds ratio for severe tachycardia with antipsychotic medication use was 4.09 (95% CI: 1.64 to 10.2).</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10071534</identifier><identifier>PMID: 33917515</identifier><language>eng</language><publisher>BASEL: Mdpi</publisher><subject>Cardiac arrhythmia ; Cardiovascular disease ; Clinical medicine ; Drug use ; General & Internal Medicine ; Heart rate ; Hospitals ; Life Sciences & Biomedicine ; Lung diseases ; Medical records ; Medicine, General & Internal ; Mental disorders ; Oxygen saturation ; Patients ; Potassium ; Psychiatry ; Psychotropic drugs ; Science & Technology ; Variables ; Vital signs</subject><ispartof>Journal of clinical medicine, 2021-04, Vol.10 (7), p.1534, Article 1534</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>0</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000638619000001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c409t-7536a14356ef8e5337033a0d196c176694e1d20abbc3e3c51af2d3e1c2dd28673</citedby><cites>FETCH-LOGICAL-c409t-7536a14356ef8e5337033a0d196c176694e1d20abbc3e3c51af2d3e1c2dd28673</cites><orcidid>0000-0001-7816-4724 ; 0000-0002-3766-4578</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038822/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038822/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27928,27929,39261,39262,53795,53797</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33917515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lim, Andy K. H.</creatorcontrib><creatorcontrib>Azraai, Meor</creatorcontrib><creatorcontrib>Pham, Jeanette H.</creatorcontrib><creatorcontrib>Looi, Wenye F.</creatorcontrib><creatorcontrib>Wirth, Daniel</creatorcontrib><creatorcontrib>Ng, Ashley S. L.</creatorcontrib><creatorcontrib>Babu, Umesh</creatorcontrib><creatorcontrib>Saluja, Bharat</creatorcontrib><title>Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation</title><title>Journal of clinical medicine</title><addtitle>J CLIN MED</addtitle><addtitle>J Clin Med</addtitle><description>The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate >= 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardia in an inpatient population of patients with mental illness, while considering factors which may contribute to tachycardia. We retrospectively analyzed data from 636 Medical Emergency Team (MET) calls occurring in 449 psychiatry inpatients in three metropolitan hospitals co-located with acute medical services, and used mixed-effects logistic regression to model the association between severe tachycardia and antipsychotic use. The median age of patients was 42 years and 39% had a diagnosis of schizophrenia or psychotic disorder. Among patients who experienced MET calls, the use of second-generation (atypical) antipsychotics was commonly encountered (70%), but the use of first-generation (conventional) antipsychotics was less prevalent (10%). Severe tachycardia was noted in 22% of all MET calls, and sinus tachycardia was the commonest cardiac rhythm. After adjusting for age, anticholinergic medication use, temperature >38 degrees C and hypoglycemia, and excluding patients with infection and venous thromboembolism, the odds ratio for severe tachycardia with antipsychotic medication use was 4.09 (95% CI: 1.64 to 10.2).</description><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Clinical medicine</subject><subject>Drug use</subject><subject>General & Internal Medicine</subject><subject>Heart rate</subject><subject>Hospitals</subject><subject>Life Sciences & Biomedicine</subject><subject>Lung diseases</subject><subject>Medical records</subject><subject>Medicine, General & Internal</subject><subject>Mental disorders</subject><subject>Oxygen saturation</subject><subject>Patients</subject><subject>Potassium</subject><subject>Psychiatry</subject><subject>Psychotropic drugs</subject><subject>Science & Technology</subject><subject>Variables</subject><subject>Vital signs</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>GIZIO</sourceid><sourceid>HGBXW</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNkl2LEzEYhQdR3GXdK-8l4I2wVPMxHxkvhFJWd2FFYet1SN-8s02ZmYxJpsv8B3-0qa21emVuEjjPezjJSZa9ZPStEDV9t4GOUVqxQuRPsnNOq2pGhRRPT85n2WUIG5qWlDln1fPsLI2yqmDFefbjHrfokSw1rCfQ3lhN5iE4sDqiIY82rsnXMMHaRe8GC-QzGgs6WtcHYvu9llifpNt-SAL2Mbwnc3IfRzMR15AbFwYbdXsYbcl1h_4Be5jIEnVH5hDt9pfji-xZo9uAl4f9Ivv28Xq5uJndffl0u5jfzSCndZxVhSg1y0VRYiOxEKKiQmhqWF0Cq8qyzpEZTvVqBQIFFEw33AhkwI3hsqzERfZh7zuMqw4NpMhet2rwttN-Uk5b9bfS27V6cFsl03tKzpPBm4OBd99HDFF1NgC2re7RjUHxglNZMs5EQl__g27c6Pt0PcXLnNHUiKwTdbWnwLsQPDbHMIyqXdHqpOhEvzrNf2R_1_rH7hFXrgmQSgE8YuknlCLFq3d_grJEy_-nF6nKXVcLN_ZR_AS_N8YH</recordid><startdate>20210406</startdate><enddate>20210406</enddate><creator>Lim, Andy K. H.</creator><creator>Azraai, Meor</creator><creator>Pham, Jeanette H.</creator><creator>Looi, Wenye F.</creator><creator>Wirth, Daniel</creator><creator>Ng, Ashley S. L.</creator><creator>Babu, Umesh</creator><creator>Saluja, Bharat</creator><general>Mdpi</general><general>MDPI AG</general><general>MDPI</general><scope>17B</scope><scope>BLEPL</scope><scope>DTL</scope><scope>DVR</scope><scope>EGQ</scope><scope>GIZIO</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7816-4724</orcidid><orcidid>https://orcid.org/0000-0002-3766-4578</orcidid></search><sort><creationdate>20210406</creationdate><title>Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation</title><author>Lim, Andy K. H. ; Azraai, Meor ; Pham, Jeanette H. ; Looi, Wenye F. ; Wirth, Daniel ; Ng, Ashley S. L. ; Babu, Umesh ; Saluja, Bharat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-7536a14356ef8e5337033a0d196c176694e1d20abbc3e3c51af2d3e1c2dd28673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Clinical medicine</topic><topic>Drug use</topic><topic>General & Internal Medicine</topic><topic>Heart rate</topic><topic>Hospitals</topic><topic>Life Sciences & Biomedicine</topic><topic>Lung diseases</topic><topic>Medical records</topic><topic>Medicine, General & Internal</topic><topic>Mental disorders</topic><topic>Oxygen saturation</topic><topic>Patients</topic><topic>Potassium</topic><topic>Psychiatry</topic><topic>Psychotropic drugs</topic><topic>Science & Technology</topic><topic>Variables</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lim, Andy K. H.</creatorcontrib><creatorcontrib>Azraai, Meor</creatorcontrib><creatorcontrib>Pham, Jeanette H.</creatorcontrib><creatorcontrib>Looi, Wenye F.</creatorcontrib><creatorcontrib>Wirth, Daniel</creatorcontrib><creatorcontrib>Ng, Ashley S. L.</creatorcontrib><creatorcontrib>Babu, Umesh</creatorcontrib><creatorcontrib>Saluja, Bharat</creatorcontrib><collection>Web of Knowledge</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Social Sciences Citation Index</collection><collection>Web of Science Primary (SCIE, SSCI & AHCI)</collection><collection>Web of Science - Social Sciences Citation Index – 2021</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lim, Andy K. H.</au><au>Azraai, Meor</au><au>Pham, Jeanette H.</au><au>Looi, Wenye F.</au><au>Wirth, Daniel</au><au>Ng, Ashley S. L.</au><au>Babu, Umesh</au><au>Saluja, Bharat</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation</atitle><jtitle>Journal of clinical medicine</jtitle><stitle>J CLIN MED</stitle><addtitle>J Clin Med</addtitle><date>2021-04-06</date><risdate>2021</risdate><volume>10</volume><issue>7</issue><spage>1534</spage><pages>1534-</pages><artnum>1534</artnum><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate >= 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardia in an inpatient population of patients with mental illness, while considering factors which may contribute to tachycardia. We retrospectively analyzed data from 636 Medical Emergency Team (MET) calls occurring in 449 psychiatry inpatients in three metropolitan hospitals co-located with acute medical services, and used mixed-effects logistic regression to model the association between severe tachycardia and antipsychotic use. The median age of patients was 42 years and 39% had a diagnosis of schizophrenia or psychotic disorder. Among patients who experienced MET calls, the use of second-generation (atypical) antipsychotics was commonly encountered (70%), but the use of first-generation (conventional) antipsychotics was less prevalent (10%). Severe tachycardia was noted in 22% of all MET calls, and sinus tachycardia was the commonest cardiac rhythm. After adjusting for age, anticholinergic medication use, temperature >38 degrees C and hypoglycemia, and excluding patients with infection and venous thromboembolism, the odds ratio for severe tachycardia with antipsychotic medication use was 4.09 (95% CI: 1.64 to 10.2).</abstract><cop>BASEL</cop><pub>Mdpi</pub><pmid>33917515</pmid><doi>10.3390/jcm10071534</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-7816-4724</orcidid><orcidid>https://orcid.org/0000-0002-3766-4578</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2077-0383 |
| ispartof | Journal of clinical medicine, 2021-04, Vol.10 (7), p.1534, Article 1534 |
| issn | 2077-0383 2077-0383 |
| language | eng |
| recordid | cdi_webofscience_primary_000638619000001CitationCount |
| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central; Web of Science - Social Sciences Citation Index – 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Cardiac arrhythmia Cardiovascular disease Clinical medicine Drug use General & Internal Medicine Heart rate Hospitals Life Sciences & Biomedicine Lung diseases Medical records Medicine, General & Internal Mental disorders Oxygen saturation Patients Potassium Psychiatry Psychotropic drugs Science & Technology Variables Vital signs |
| title | Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-16T17%3A08%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_webof&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Severe%20Tachycardia%20Associated%20with%20Psychotropic%20Medications%20in%20Psychiatric%20Inpatients:%20A%20Study%20of%20Hospital%20Medical%20Emergency%20Team%20Activation&rft.jtitle=Journal%20of%20clinical%20medicine&rft.au=Lim,%20Andy%20K.%20H.&rft.date=2021-04-06&rft.volume=10&rft.issue=7&rft.spage=1534&rft.pages=1534-&rft.artnum=1534&rft.issn=2077-0383&rft.eissn=2077-0383&rft_id=info:doi/10.3390/jcm10071534&rft_dat=%3Cproquest_webof%3E2641042189%3C/proquest_webof%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2641042189&rft_id=info:pmid/33917515&rfr_iscdi=true |