Rates of delirium associated with calcium channel blockers compared to diuretics, renin-angiotensin system agents and beta-blockers: An electronic health records network study

Harrison, Paul J.; Luciano, Sierra; Colbourne, Lucy

doi:10.1177/0269881120936501

Cited by 24 publications

(26 citation statements)

References 44 publications

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“…We used the TriNetX Analytics Network, a global federated network that captures anonymised data from electronic health records in 54 health-care organisations in the USA, totalling 69·8 million patients. The TriNetX platform and its functionalities have been described elsewhere, 16 and more details are provided in the appendix (pp 1–2 ). Available data include demographics, diagnoses (using ICD-10 codes), procedures, medications, and measurements (eg, laboratory test results and body-mass index).…”

Section: Methodsmentioning

confidence: 99%

Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA

Taquet

Luciano

Geddes

et al. 2021

The Lancet Psychiatry

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1,232

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Background Adverse mental health consequences of COVID-19, including anxiety and depression, have been widely predicted but not yet accurately measured. There are a range of physical health risk factors for COVID-19, but it is not known if there are also psychiatric risk factors. In this electronic health record network cohort study using data from 69 million individuals, 62 354 of whom had a diagnosis of COVID-19, we assessed whether a diagnosis of COVID-19 (compared with other health events) was associated with increased rates of subsequent psychiatric diagnoses, and whether patients with a history of psychiatric illness are at a higher risk of being diagnosed with COVID-19. Methods We used the TriNetX Analytics Network , a global federated network that captures anonymised data from electronic health records in 54 health-care organisations in the USA, totalling 69·8 million patients. TriNetX included 62 354 patients diagnosed with COVID-19 between Jan 20, and Aug 1, 2020. We created cohorts of patients who had been diagnosed with COVID-19 or a range of other health events. We used propensity score matching to control for confounding by risk factors for COVID-19 and for severity of illness. We measured the incidence of and hazard ratios (HRs) for psychiatric disorders, dementia, and insomnia, during the first 14 to 90 days after a diagnosis of COVID-19. Findings In patients with no previous psychiatric history, a diagnosis of COVID-19 was associated with increased incidence of a first psychiatric diagnosis in the following 14 to 90 days compared with six other health events (HR 2·1, 95% CI 1·8–2·5 vs influenza; 1·7, 1·5–1·9 vs other respiratory tract infections; 1·6, 1·4–1·9 vs skin infection; 1·6, 1·3–1·9 vs cholelithiasis; 2·2, 1·9–2·6 vs urolithiasis, and 2·1, 1·9–2·5 vs fracture of a large bone; all p<0·0001). The HR was greatest for anxiety disorders, insomnia, and dementia. We observed similar findings, although with smaller HRs, when relapses and new diagnoses were measured. The incidence of any psychiatric diagnosis in the 14 to 90 days after COVID-19 diagnosis was 18·1% (95% CI 17·6–18·6), including 5·8% (5·2–6·4) that were a first diagnosis. The incidence of a first diagnosis of dementia in the 14 to 90 days after COVID-19 diagnosis was 1·6% (95% CI 1·2–2·1) in people older than 65 years. A psychiatric diagnosis in the previous year was associated with a higher incidence of COVID-19 diagnosis (relative risk 1·65, 95% CI 1·59–1·71; p<0·0001). This risk was independent of known physical health risk factors for COVID-19, but we cannot exclude possible residual confounding by socioeconomic factors. Interpretation Survivors of COVID-19 appear to be at increased risk of psychiatric sequelae, and a psychiatric diagnosis ...

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Section: Methodsmentioning

confidence: 99%

Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA

Taquet

Luciano

Geddes

et al. 2021

The Lancet Psychiatry

Self Cite

1,232

1,125

View full text Add to dashboard Cite

show abstract

“…We used data from TriNetX Analytics Network (http://www.trinetx.com), a global federated research network capturing anonymized data from EHR in 54 healthcare organizations in the USA, totalling 69.8 million patients. The TriNetX platform and its functionalities have been described elsewhere 17 . The healthcare organizations are a mixture of hospitals, primary care, and specialist providers.…”

Section: Methodsmentioning

confidence: 99%

Bidirectional associations between COVID-19 and psychiatric disorder: a study of 62,354 COVID-19 cases

Taquet

Luciano

Geddes

et al. 2020

Preprint

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Background: Adverse mental health consequences of COVID-19, including anxiety and depression, have been widely predicted but not yet accurately measured. There are a range of physical health risk factors for COVID-19, but it is not known if there are also psychiatric risk factors. Methods: We addressed both questions using cohort studies derived from an electronic health records (EHR) network of 69 million patients including over 62,000 cases of COVID-19. Propensity score matching was used to control for confounding by risk factors for COVID-19 and for more severe illness. Findings: In patients with no prior psychiatric history, COVID-19 was associated with an increased incidence of psychiatric diagnoses in the three months after infection compared to 6 other health events (hazard ratio [95% CI] 2.1 [1.8-2.5] compared to influenza; 1.7 [1.5-1.9] compared to other respiratory tract infections; 1.6 [1.4-1.9] compared to skin infection; 1.6 [1.3.1-9] compared to cholelithiasis; 2.2 [1.9-2.6] compared to urolithiasis, and 2.1 [1.9-2.5] compared to fracture of a large bone; all p<0.0001). The increase was greatest for anxiety disorders but also present for depression, insomnia, and dementia. The results were robust to several sensitivity analyses. There was a ~30% reduction in psychiatric diagnoses in the total EHR population over the same period. A psychiatric diagnosis in the previous year was associated with a 65% higher incidence of COVID-19 (relative risk 1.65, 95% CI: 1.59-1.71, p<0.0001). This was independent of known physical health risk factors for COVID-19. Interpretation: COVID-19 infection has both psychiatric sequelae and psychiatric antecedents. Survivors have an increased rate of new onset psychiatric disorders, and prior psychiatric disorders are associated with a higher risk of COVID-19. The findings have implications for research into aetiology and highlight the need for clinical services to provide multidisciplinary follow-up, and prompt detection and treatment.

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“…Details have been described elsewhere. 6,7 Briefly, the network allows patient cohorts to be created based on defined inclusion and exclusion criteria. Two cohorts can then be compared for other characteristics and outcomes.…”

Section: Methodsmentioning

confidence: 99%

Incidence of neurodegenerative and cerebrovascular diseases associated with antihypertensive drug classes

2021

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Antihypertensive drugs (AHTs) are associated with lowered risks of neurodegenerative diseases and stroke. However, the relative risks associated with different AHT classes are unclear. Using an electronic health record network with 34 million eligible patients, we compared rates of these disorders over a 2-year period, in propensity score-matched cohorts of people taking calcium channel blockers (CCBs) compared with those taking other AHT classes. CCBs were associated with a higher incidence of all disorders compared with renin-angiotensin system agents, and a higher incidence of dementia and cerebrovascular disease compared with diuretics. CCBs were associated with a lower incidence of movement disorders and cerebrovascular disease compared with beta-blockers. The data show that AHT classes confer differential risks of neurodegenerative and cerebrovascular diagnoses.

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Rates of delirium associated with calcium channel blockers compared to diuretics, renin-angiotensin system agents and beta-blockers: An electronic health records network study

Cited by 24 publications

References 44 publications

Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA

Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA

Bidirectional associations between COVID-19 and psychiatric disorder: a study of 62,354 COVID-19 cases

Incidence of neurodegenerative and cerebrovascular diseases associated with antihypertensive drug classes

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