Evidence map›Paper›PMID 39586948›Full record

ArticleJournal of general internal medicine2025

Antipsychotics and Risk of Acute Respiratory Failure in U.S. Medicare Beneficiaries with Chronic Obstructive Pulmonary Disease.

Silvia Perez-Vilar, Andrew D Mosholder, Elizabeth R Smith, Hye Seung Lee, An-Chi Lo, Marc Stone, Amy Brehm, Yueqin Zhao, Armen Avagyan, Kira Leishear and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. COPD and Schizophrenia.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Silvia Perez-VilarCenter for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA. silvia.perezvilar@fda.hhs.gov.ORCID 0000-0003-1272-1502
Andrew D MosholderCenter for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
Elizabeth R SmithAcumen LLC, Burlingame, CA, USA.
Hye Seung LeeCenter for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
An-Chi LoAcumen LLC, Burlingame, CA, USA.
Marc StoneCenter for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
Amy BrehmAcumen LLC, Burlingame, CA, USA.
Yueqin ZhaoCenter for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
Armen AvagyanAcumen LLC, Burlingame, CA, USA.
Kira LeishearCenter for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
Michael WerneckeAcumen LLC, Burlingame, CA, USA.
Thomas E MaCurdyAcumen LLC, Burlingame, CA, USA.
Jeffrey A KelmanCenters for Medicare & Medicaid Services, Washington, DC, USA.
David J GrahamCenter for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.

Funding

U.S. Food and Drug Administration GS-10F-0133S
6 · The paper itself

Abstract

importanceAcute respiratory failure (ARF) associated with antipsychotic use has been documented through case reports and population-based studies.

objectiveTo assess whether the recent use of antipsychotics is associated with an increased risk of ARF in U.S. Medicare beneficiaries with chronic obstructive pulmonary disease. DESIGN, SETTING, AND

participantsCase-crossover study conducted among U.S. Fee-for-Service Medicare beneficiaries with chronic obstructive pulmonary disease hospitalized with ARF, from January 1, 2007, through December 31, 2019. EXPOSURE: Oral antipsychotics. MAIN OUTCOME(S) AND MEASURE(S): Adjusted odds ratios (aOR) and 95% confidence intervals (CI) for ARF requiring invasive mechanical ventilation associated with the use of antipsychotics in the case period (days -14 to -1) compared to the control period (days -75 to -88).

resultsWe identified 145,018 cases (mean age 69.4 years, 57.2% female). Of these, 2,003 had antipsychotic use only during the case period and 1,728 only during the control period. The aOR of ARF within 14 days after antipsychotic use was 1.13 (95% CI, 1.06, 1.20). The risk increased with increasing age, being statistically significant in patients ages 75-84 years (aOR: 1.37 [95% CI, 1.17, 1.60]) and 85 + years (aOR: 1.50 [95% CI, 1.20, 1.89]), but not in beneficiaries under 75 years of age (aOR 18-49 years: 1.01 [95% CI, 0.85, 1.20]; 50-64 years: 1.03 [95% CI, 0.92, 1.15]; 65-74 years: 1.12 [95% CI, 0.98, 1.27]). CONCLUSIONS AND RELEVANCE: Recent antipsychotic use by Medicare beneficiaries with chronic obstructive pulmonary disease was associated with an increased risk of ARF in those aged 75 years and older.

Indexed as

Antipsychotic AgentsMedicarePulmonary Disease, Chronic ObstructiveRespiratory InsufficiencyAgedAged, 80 and overCross-Over StudiesFemaleHumansMaleMiddle AgedRisk FactorsUnited StatesAntipsychotic Agents

Identifiers

PMID39586948
PMCPMC11861491

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.