Chang Chia-Ming, Wu Kuan-Yi, Chiu Yu-Wen, Wu Hsiao-Ting, Tsai Yu-Ting, Chau Yeuk-Lun, Tsai Hui-Ju
Department of Psychiatry, Chang Gung Memorial Hospital, Lin-Kou & Chang Gung University, Taoyuan, Taiwan.
Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
Pharmacoepidemiol Drug Saf. 2016 Aug;25(8):918-27. doi: 10.1002/pds.3995. Epub 2016 Mar 28.
We aimed to investigate the association between psychotropic treatment and risk of burn injury in individuals with mental illness.
A nested case-control study was conducted by using the National Health Insurance Research Database in Taiwan. A total of 3187 cases with burn injury under International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 940-949 and 19 122 matched controls were identified from 2003 to 2012. Four kinds of psychotropic agents (antipsychotics (APs), antidepressants (ADs), benzodiazepines, and z-drugs) were examined. Psychotropic exposure status was measured, and a set of potential confounding factors was adjusted in the analyses. Conditional logistic regressions were applied to determine the effect of psychotropic use on burn injury.
A significant increased risk of burn injury was observed among psychotropic users compared with non-users (adjusted odds ratio (AOR) = 1.45, 95%CI = 1.31-1.61). When classifying psychotropic users into current, new, continuous, and past users, a significant elevated risk of burn injury was found across all groups (AOR = 1.76, 95%CI = 1.54-2.00 in current users; AOR = 2.02, 95%CI = 1.55-2.65 in new users; AOR = 1.72, 95%CI = 1.50-1.96 in continuous users; and AOR = 1.35, 95%CI = 1.21-1.51 in past users). When assessing each individual kind of examined psychotropic agents, a significant elevated risk of burn injury was found among users of APs, ADs, benzodiazepines, and z-drugs except for current and continuous users of z-drugs.
The results demonstrate an elevated risk of burn injury among individuals with current psychotropic use. The findings underscore the need for greater attention to be given to the cognitive performance and psychomotor abilities of individuals taking psychotropic medications in order to prevent the occurrence of burn injury. Copyright © 2016 John Wiley & Sons, Ltd.
我们旨在调查精神疾病患者中精神药物治疗与烧伤风险之间的关联。
利用台湾国民健康保险研究数据库进行了一项巢式病例对照研究。从2003年至2012年，共识别出3187例国际疾病分类第九版临床修订本（ICD - 9 - CM）编码为940 - 949的烧伤患者以及19122名匹配对照。研究了四种精神药物（抗精神病药（APs）、抗抑郁药（ADs）、苯二氮䓬类药物和Z类药物）。测量了精神药物暴露状态，并在分析中对一组潜在混杂因素进行了调整。应用条件逻辑回归来确定精神药物使用对烧伤的影响。
与未使用精神药物者相比，使用精神药物者烧伤风险显著增加（调整优势比（AOR）= 1.45，95%置信区间（CI）= 1.31 - 1.61）。当将精神药物使用者分为当前使用者、新使用者、持续使用者和既往使用者时，所有组的烧伤风险均显著升高（当前使用者的AOR = 1.76，95%CI = 1.54 - 2.00；新使用者的AOR = 2.02，95%CI = 1.55 - 2.65；持续使用者的AOR = 1.72，95%CI = 1.50 - 1.96；既往使用者的AOR = 1.35，95%CI = 1.21 - 1.51）。在评估每种被研究的精神药物时，除了Z类药物的当前和持续使用者外，APs、ADs、苯二氮䓬类药物和Z类药物使用者的烧伤风险均显著升高。
结果表明当前使用精神药物的个体烧伤风险升高。这些发现强调需要更加关注服用精神药物个体的认知表现和精神运动能力，以预防烧伤的发生。版权所有© 2016约翰威立父子有限公司。
