Quetiapine therapy in critically injured trauma patients is associated with an increased risk of pulmonary complications |
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| Institution: | 1. Trauma Service, Scripps Mercy Hospital, 4077 Fifth Avenue, San Diego, CA, 92103, USA;2. Pharmacy Department, Scripps Mercy Hospital, 4077 Fifth Avenue, San Diego, CA, 92103, USA;1. Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA;2. Department of Surgery, Scripps Mercy Hospital, San Diego, CA, USA;1. School of Medicine, Oregon Health & Science University, Portland, OR, USA;2. Department of Surgery, Division of Surgical Oncology, Oregon Health & Science University, Portland, OR, USA;3. School of Public Health, Texas A and M University, College Station, TX, USA;1. Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada;2. Department of Surgery, University of British Columbia, Island Medical Program, Victoria, British Columbia, Canada;1. BC Cancer-Sindi Ahluwalia Hawkins Centre, Dept. of Surgical Oncology, 399 Royal Ave, Kelowna, BC, V1Y 5L3, Canada;2. University of British Columbia Southern Medical Program, 2312 Pandosy Street, Kelowna, BC, V1Y 1T3, Canada;1. Oregon Health & Science University, Department of Surgery, 3181 SW Sam Jackson Park Rd, Portland, 97239, OR, USA;2. Legacy Cancer Institute, Legacy Medical Group Surgical Oncology, 1040 NW 22nd Ave, Suite 560, Portland, 97227, OR, USA;1. Oregon Health & Science University, Portland, OR, USA;2. University of California San Francisco, San Francisco, CA, USA |
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| Abstract: | BackgroundThe aim of this study was to evaluate quetiapine-associated pulmonary complications (PC) in critically injured trauma patients.MethodsInjured adults admitted during 2016 to the ICU at a Level I trauma center were analyzed. Outcomes were evaluated by competing risks survival analysis.ResultsOf 254 admissions, 40 (15.7%) had PC and 214 (84.3%) were non-events. PC patients were more severely injured, had longer hospital stays and were more likely to die. Patients administered quetiapine were more likely to develop PC and acquire PC earlier than those without quetiapine. Quetiapine was a positive risk factor for PC (sHR 2.24, p = 0.013). Stratification by ventilator use revealed non-ventilated patients administered quetiapine had the highest risk for PC (sHR 4.66, p = 0.099).ConclusionsQuetiapine exposure in critically injured trauma patients was associated with increased risk of PC. Guidelines for treatment of delirium with quetiapine in critically injured trauma patients should account for this risk. |
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| Keywords: | Pulmonary complications Trauma Sedation Delirium Quetiapine |
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