Proton-Pump Inhibitors and Long-Term Risk of Community-Acquired Pneumonia in Older Adults.
J Am Geriatr Soc
; 66(7): 1332-1338, 2018 07.
Article
en En
| MEDLINE
| ID: mdl-29676433
ABSTRACT
OBJECTIVES:
To estimate associations between long-term use of proton pump inhibitors (PPIs) and pneumonia incidence in older adults in primary care.DESIGN:
Longitudinal analyses of electronic medical records.SETTING:
EnglandPARTICIPANTS:
Individuals aged 60 and older in primary care receiving PPIs for 1 year or longer (N=75,050) and age- and sex-matched controls (N=75,050). MEASUREMENTS Net hazard ratios for pneumonia incidence in Year 2 of treatment were estimated using the prior event rate ratio (PERR), which adjusts for pneumonia incidence differences before initiation of treatment. Inverse probability weighted models adjusted for 78 demographic, disease, medication, and healthcare usage measures.RESULTS:
During the second year after initiating treatment, PPIs were associated with greater hazard of incident pneumonia (PERR-adjusted hazard ratio=1.82, 95% confidence interval=1.27-2.54), accounting for pretreatment pneumonia rates. Estimates were similar across age and comorbidity subgroups. Similar results were also obtained from propensity score- and inverse probability-weighted models.CONCLUSION:
In a large cohort of older adults in primary care, PPI prescription was associated with greater risk of pneumonia in the second year of treatment. Results were robust across alternative analysis approaches. Controversies about the validity of reported short-term harms of PPIs should not divert attention from potential long-term effects of PPI prescriptions on older adults.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neumonía
/
Infecciones Comunitarias Adquiridas
/
Inhibidores de la Bomba de Protones
/
Antiulcerosos
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Am Geriatr Soc
Año:
2018
Tipo del documento:
Article
País de afiliación:
Reino Unido