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Mortality and morbidity following postoperative use of short‐term, low‐dose quetiapine vs risperidone in patients with diabetes: Analysis using a national inpatient database
Author(s) -
Sato Daisuke,
Uda Kazuaki,
Kumazawa Ryosuke,
Matsui Hiroki,
Yasunaga Hideo
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.5164
Subject(s) - quetiapine , medicine , risperidone , propensity score matching , retrospective cohort study , diabetes mellitus , pediatrics , psychiatry , schizophrenia (object oriented programming) , endocrinology
Abstract Purpose Short‐term, low‐dose quetiapine is used to treat postoperative delirium and insomnia. Quetiapine is contraindicated for patients with diabetes in Japan because there have been several case reports of diabetic ketoacidosis (DKA) in patients receiving long‐term, high‐dose quetiapine. However, because safety of short‐term, low‐dose quetiapine remains controversial, it is prescribed for patients with diabetes in real‐world clinical practice. The present study aimed to compare in‐hospital mortality and morbidity between short‐term, low‐dose quetiapine and risperidone in postoperative patients with diabetes. Methods We used a national inpatient database in Japan to perform a retrospective cohort study. We identified hospitalized patients with diabetes who underwent scheduled elective surgery and received oral quetiapine 200 mg/d or less or oral risperidone 4 mg/d or less within 7 days of surgery between July 2010 and March 2018. We performed one‐to‐one propensity score‐matched analyses to compare outcomes between patients with quetiapine and risperidone. The primary outcome was in‐hospital mortality. The secondary outcome was infectious complications (pneumonia, urinary tract infection, surgical site infection, and sepsis). Results Propensity score matching created 665 pairs of patients who received quetiapine or risperidone. The primary outcome was observed in 19 (2.9%) of the quetiapine group and 11 (1.7%) of the risperidone group (relative risk, 1.27; 95% confidence interval, 0.97–1.68; P = .14). The secondary outcome did not differ significantly between the groups. Conclusion In terms of mortality and infectious outcomes, safety of quetiapine and risperidone may be comparable.