Antipsychotic Use Among 1144 Patients After Aneurysmal Subarachnoid Hemorrhage.

Autor:	Paavola JT; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland.; School of Medicine (J.T.P., N.V., O.-P.K., H.V., J.E.J., J.H.), University of Eastern Finland, Kuopio., Väntti N; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland.; School of Medicine (J.T.P., N.V., O.-P.K., H.V., J.E.J., J.H.), University of Eastern Finland, Kuopio., Junkkari A; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland., Huttunen TJ; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland., von Und Zu Fraunberg M; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland., Koivisto T; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland., Kämäräinen OP; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland.; School of Medicine (J.T.P., N.V., O.-P.K., H.V., J.E.J., J.H.), University of Eastern Finland, Kuopio., Lång M; Neurointensive Care, Institute of Clinical Medicine (M.L.), University of Eastern Finland, Kuopio., Meretoja A; Department of Neurology, Helsinki University Hospital, Finland (A.M.).; Department of Medicine at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia (A.M.)., Räikkönen K; Department of Psychology and Logopedics, University of Helsinki, Finland (K.R.)., Viinamäki H; Psychiatry (H.V.), Kuopio University Hospital and Institute of Clinical Medicine, Finland.; School of Medicine (J.T.P., N.V., O.-P.K., H.V., J.E.J., J.H.), University of Eastern Finland, Kuopio., Jääskeläinen JE; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland.; School of Medicine (J.T.P., N.V., O.-P.K., H.V., J.E.J., J.H.), University of Eastern Finland, Kuopio., Huttunen J; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland.; School of Medicine (J.T.P., N.V., O.-P.K., H.V., J.E.J., J.H.), University of Eastern Finland, Kuopio., Lindgren AE; From the Neurosurgery of NeuroCenter (J.T.P., N.V., A.J., T.J.H., M.v.u.z.F., T.K., O.-P.K., J.E.J., J.H., A.E.L.), Kuopio University Hospital and Institute of Clinical Medicine, Finland.
Jazyk:	angličtina
Zdroj:	Stroke [Stroke] 2019 Jul; Vol. 50 (7), pp. 1711-1718. Date of Electronic Publication: 2019 Jun 06.
DOI:	10.1161/STROKEAHA.119.024914
Abstrakt:	Background and Purpose- At acute phase and neurointensive care, patients with aneurysmal subarachnoid hemorrhage (aSAH) may become agitated or delirious. We found no previous studies on psychotic disorders or antipsychotic drug (APD) use by long-term aSAH survivors. We defined the APD use and its risk factors among 12-month survivors of aSAH in an Eastern Finnish population-based cohort with long-term follow-up. Methods- We analyzed APD use in 1144 consecutive patients with aSAH alive at 12 months of the Kuopio intracranial aneurysm patient and family database and their age, sex, and birth municipality matched controls (3:1; n=3432) from 1995 to 2013 and median follow-up of 9 years. Using the Finish nationwide health registries, we obtained drug purchase and hospital discharge data. Results- In total, 140 (12%) of the 1144 patients started APD use first time after aSAH (index date), in contrast to 145 (4%) of the 3432 matched population controls. The cumulative rate of starting APD was 6% at 1 year and 9% at 5 years, in contrast to 1% and 2% in the controls, respectively. The rates at 1 and 5 years were only 1% and 2% in the 489 patients with a good condition (modified Rankin Scale score, 0 or 1 at 12 months; no shunt, intracerebral hemorrhage, or intraventricular hemorrhage). Instead, the highest rate of APD use, 23% at 5 years was among the 192 patients shunted for hydrocephalus after aSAH. Eighty-eight (63%) of the 140 aSAH patients with APD use had also concomitant antidepressant or antiepileptic drug use. Conclusions- The 12-month survivors of aSAH were significantly more likely to be started on APD after aSAH than their matched population controls. These patients often used antidepressant and antiepileptic drugs concomitantly. The use of APDs strongly correlated with signs of brain injury after aSAH, with low use if no signs of significant brain injury were present.
Databáze:	MEDLINE
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