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Multicenter Study Links Peri-Op SSRI Use to Adverse Outcomes

Increased odds of in-hospital mortality, bleeding, 30-day readmission, after adjustment
TUESDAY, April 30 (HealthDay News) -- Perioperative use of selective serotonin reuptake inhibitors (SSRIs) is associated with adverse outcomes, including in-hospital mortality, bleeding, and 30-day readmission, according to a multicenter study published online April 29 in JAMA Internal Medicine.
In an effort to examine whether perioperative use of SSRIs correlated with adverse outcomes, Andrew D. Auerbach, M.D., M.P.H., from the University of California in San Francisco, and colleagues conducted a retrospective study of 530,416 patients aged 18 years or older who underwent major surgery from 2006 through 2008 at 375 U.S. hospitals.
The researchers found that patients receiving SSRIs were significantly more likely to have obesity, chronic pulmonary disease, hypothyroidism, and depression. After adjustment, the odds of in-hospital mortality, bleeding, and readmission at 30-days were increased for patients receiving SSRIs (adjusted odds ratios, 1.20, 1.09, and 1.22, respectively). In propensity-matched analyses, the outcomes were similar, although for patients with depression the risk of inpatient mortality was attenuated.
"Receiving SSRIs in the perioperative period is associated with a higher risk for adverse events," the authors write. "Determining whether patient factors or SSRIs themselves are responsible for elevated risks requires prospective study."
Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1682366#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1682366 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1682367 )
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