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Bruun SB, Petersen I, Kristensen NR, et al. Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study. Clin Epidemiol. 2018;10:1053-1071doi: 10.2147/CLEP.S166309.
Bruun, S. B., Petersen, I., Kristensen, N. R., Cronin-Fenton, D., & Pedersen, A. B. (2018). Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study. Clinical epidemiology, 101053-1071. https://doi.org/10.2147/CLEP.S166309
Bruun, Stine Bakkensen, et al. "Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study." Clinical epidemiology vol. 10 (2018): 1053-1071. doi: https://doi.org/10.2147/CLEP.S166309
Bruun SB, Petersen I, Kristensen NR, Cronin-Fenton D, Pedersen AB. Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study. Clin Epidemiol. 2018 Aug 27;10:1053-1071. doi: 10.2147/CLEP.S166309. eCollection 2018. PMID: 30214311; PMCID: PMC6118260.
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Clin Epidemiol. 2018 Aug 27;10:1053-1071. doi: 10.2147/CLEP.S166309. eCollection 2018.

Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study.

Clinical epidemiology

Stine Bakkensen Bruun, Irene Petersen, Nickolaj Risbo Kristensen, Deirdre Cronin-Fenton, Alma Becic Pedersen

Affiliations

  1. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark, [email protected].
  2. Department of Primary Care and Population Health, University College London, London, UK.

PMID: 30214311 PMCID: PMC6118260 DOI: 10.2147/CLEP.S166309

Abstract

PURPOSE: To examine the association between selective serotonin reuptake inhibitor (SSRI) use and mortality, postoperative complications, and quality of in-hospital care in hip fracture patients.

PATIENTS AND METHODS: The study was a nationwide cohort study based on individual-level linked, prospectively collected data from Danish population-based national registries covering all hospitals in Denmark. The health care system in Denmark is tax-funded, and all citizens have equal access to health care services. We included patients with first-time hospitalization due to hip fracture undergoing surgery from 2006-2016. We estimated the risk of 30-day mortality, any unplanned readmission, any reoperation, specific postoperative complications including cardiovascular events and major bleeding, and quality of in-hospital care using Cox and Poisson regression analyses comparing current and former SSRI users with non-users.

RESULTS: In 68,487 hip fracture patients, 13,272 (19%) were current SSRI users, 2,777 (4%) were former SSRI users, and 52,438 (77%) were SSRI non-users. The 30-day mortality risk was 13% in current SSRI users (HR 1.16, 1.10-1.21) and 12% in former (HR 1.15, 1.04-1.27) compared with 10% in non-users. The HR for any unplanned readmission was 1.11 (1.02-1.20) in current and 1.13 (1.01-1.27) in former SSRI users and for any reoperation 1.21 (1.11-1.31) in current and 1.04 (0.84-1.28) in former SSRI users compared with non-users. The risk of venous thromboembolism, myocardial infarction, stroke, and bleeding were similar irrespective of SSRI use. No association between current and former SSRI use and quality of in-hospital care was found.

CONCLUSION: In patients undergoing hip fracture surgery, 30-day mortality and overall readmission risk were elevated in both current and former SSRI users compared with non-users. Those currently using SSRI had a 26% increased reoperation risk compared with non-users. However, SSRI use was not associated with increased risk of other postoperative complications and lower quality of in-hospital care. A limitation of this study was the inability to control for potential confounding of social deprivation.

Keywords: cohort studies; hip fracture; mortality; postoperative complications; quality of care; selective serotonin reuptake inhibitors

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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