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抗精神病药与静脉血栓栓塞风险:基于人群的病例对照研究。

Antipsychotics and risk of venous thromboembolism: A population-based case-control study.

机构信息

Nordic School of Public Health, Gothenburg, Sweden;

出版信息

Clin Epidemiol. 2009 Aug 9;1:19-26. doi: 10.2147/clep.s4969.

Abstract

During the last decade, the risk of venous thromboembolism (VTE) has been reported in users of antipsychotic drugs. However, the reports have been inconclusive. This study aimed to determine the relative risk of VTE in antipsychotic drug users. Using data from medical databases in North Jutland and Aarhus Counties, Denmark, and the Danish Civil Registration System, we identified 5,999 cases with a first-time diagnosis of VTE and, based on risk set sampling, 59,990 sex- and age-matched population controls during 1997-2005. Users of antipsychotic drugs were identified from population-based prescription databases and categorized based on filled prescriptions prior to admission date for VTE or index date for controls as current (at least one prescription within 90 days), recent (at least one prescription within 91-180 days), former (at least one prescription within 181-365 days) or nonusers (no recorded prescription within 365 days). Compared with nonusers, current users of any antipsychotic drugs had an increased risk of VTE (adjusted relative risk [ARR]: 1.99, 95% confidence interval [CI]: 1.69-2.34). Former users of any antipsychotic drugs had a nonsignificant elevated risk of VTE compared with nonusers (ARR: 1.54, 95% CI: 0.99-2.40, p-value: 0.056). In conclusion, users of antipsychotic drugs have an increased risk of VTE, compared with nonusers, which might be due to the treatment itself, to lifestyle factors, to the underlying disease, or to residual confounding.

摘要

在过去的十年中,抗精神病药物使用者发生静脉血栓栓塞(VTE)的风险已被报道。然而,这些报告尚无定论。本研究旨在确定抗精神病药物使用者发生 VTE 的相对风险。我们使用丹麦北日德兰和奥胡斯郡的医疗数据库以及丹麦民事登记系统的数据,确定了 5999 例首次诊断为 VTE 的病例,并根据风险集抽样,确定了 1997 年至 2005 年期间与病例年龄和性别相匹配的 59990 名人群对照。抗精神病药物使用者的信息来自基于人群的处方数据库,并根据入院日期前(VTE 病例)或对照索引日期(对照)前的用药情况分为当前(90 天内至少有 1 张处方)、近期(91-180 天内至少有 1 张处方)、既往(181-365 天内至少有 1 张处方)或未使用者(365 天内无记录处方)。与未使用者相比,当前使用任何抗精神病药物的患者发生 VTE 的风险增加(调整后的相对风险 [ARR]:1.99,95%置信区间 [CI]:1.69-2.34)。与未使用者相比,既往使用任何抗精神病药物的患者 VTE 的风险升高,但无统计学意义(ARR:1.54,95% CI:0.99-2.40,p 值:0.056)。总之,与未使用者相比,抗精神病药物使用者发生 VTE 的风险增加,这可能是由于治疗本身、生活方式因素、基础疾病或残余混杂因素所致。

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