Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-22T17:25:35.899Z Has data issue: false hasContentIssue false

Psychotropic drugs use and risk of heat-related hospitalisation

Published online by Cambridge University Press:  21 May 2007

Karin Martin-Latry*
Affiliation:
Université Victor Segalen Bordeaux 2, France Département de Pharmacologie, CHU Bordeaux, France Inserm U657, Bordeaux, France
Marie-Pierre Goumy
Affiliation:
Service des urgences-réanimation, Centre Hospitalo-Universitaire de Saint-André, Bordeaux, France
Philippe Latry
Affiliation:
Direction Régionale du Service Médical de l’Assurance Maladie d’Aquitaine, CNAM-TS, France
Claude Gabinski
Affiliation:
Service des urgences-réanimation, Centre Hospitalo-Universitaire de Saint-André, Bordeaux, France
Bernard Bégaud
Affiliation:
Université Victor Segalen Bordeaux 2, France Département de Pharmacologie, CHU Bordeaux, France Inserm U657, Bordeaux, France
Isabelle Faure
Affiliation:
Service des urgences-réanimation, Centre Hospitalo-Universitaire de Saint-André, Bordeaux, France
Hélène Verdoux
Affiliation:
Université Victor Segalen Bordeaux 2, France Inserm U657, Bordeaux, France
*
Corresponding author. Inserm U657, Département de Pharmacologie, Université Victor Segalen, 146 rue Léo Saignat, 33 076 Bordeaux cedex, France. Tel: +33 557 571 561; fax: +33 557 574 660. E-mail address: [email protected] (K. Martin-Latry).
Get access

Abstract

Objective

To assess if use of psychotropic drugs is associated with an increased risk of admission for heat-related pathologies during a heat wave period.

Method

We conducted a matched case–control study. Cases were defined as subjects admitted to an emergency department for heat-related pathology (hyperthermia or heat stroke) over the August 2003 heat wave. Controls were defined as subjects living in the same area but not hospitalised over the same period and who had at least one prescription form submitted for refunding by the social security insurance in July 2003. Multivariate analyses were used to identify psychotropic drugs independently associated with hospital referral during the heat wave period.

Results

Out of the 1405 patients admitted to the emergency department, 56 (4%) presented with heat-related pathology. The mean age of cases was 83 years. Multivariate analyses showed that cases were more likely than controls to be treated with anticholinergic drugs (OR 6.0, 95% CI 1.8–19.6), antipsychotics (OR 4.6, 95% CI 1.9–11.2) or anxiolytics (OR 2.4, 95% CI 1.3–4.4).

Conclusion

In special risk situations such as heat waves, the risk/benefit ratio of psychotropic drugs which could interfere with body temperature regulation has to be carefully assessed, particularly in the elderly.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

AFSSaPS. Mise au point sur le bon usage des médicaments en cas de vague de chaleur Available athttp://agmed.sante.gouv.fr/htm/10/canicule/canicul1.pdf. 2005.Google Scholar
Bark, N.Deaths of psychiatric patients during heat waves. Psychiatr Serv 1998;49:10881090.CrossRefGoogle ScholarPubMed
Basu, R., Samet, J.M.Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence. Epidemiol Rev 2002;24:190202.Google ScholarPubMed
Bouchama, A., Knochel, J.P.Heat stroke. N Engl J Med 2002;346:19781988.CrossRefGoogle ScholarPubMed
Diaz, J., Jordan, A., Garcia, R., Lopez, C., Alberdi, J.C., Hernandez, E.et al.Heat waves in Madrid 1986–1997: effects on the health of the elderly. Int Arch Occup Environ Health 2002;75:163170.CrossRefGoogle ScholarPubMed
Grize, L., Huss, A., Thommen, O., Schindler, C., Braun-Fahrlander, C.Heat wave 2003 and mortality in Switzerland. Swiss Med Wkly 2005;135:200205.Google ScholarPubMed
Hemon, D., Jougla, E.The heat wave in France in August 2003. Rev Epidemiol Sante Publique 2004;52:35.Google ScholarPubMed
Jones, T.S., Liang, A.P., Kilbourne, E.M., Griffin, M.R., Patriarca, P.A., Wassilak, S.G.et al.Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, MO. JAMA 1982;247:33273331.Google Scholar
Kaiser, R., Rubin, C.H., Henderson, A.K., Wolfe, M.I., Kieszak, S., Parrott, C.L.et al.Heat-related death and mental illness during the 1999 Cincinnati heat wave. Am J Forensic Med Pathol 2001;22:303307.CrossRefGoogle ScholarPubMed
Katsouyanni, K., Trichopoulos, D., Zavitsanos, X., Touloumi, G.The 1987 Athens heatwave. Lancet 1988;2:573.CrossRefGoogle ScholarPubMed
Kilbourne, E.M., Choi, K., Jones, T.S., Thacker, S.B.Risk factors for heatstroke. A case-control study. JAMA 1982;247:33323336.CrossRefGoogle ScholarPubMed
Kosatsky, T.The 2003 European heat waves. Euro Surveill 2005;10:148149.CrossRefGoogle ScholarPubMed
Kwok, J.S., Chan, T.Y.Recurrent heat-related illnesses during antipsychotic treatment. Ann Pharmacother 2005;39:19401942.CrossRefGoogle ScholarPubMed
Ledrans, M., Pirard, P., Tillaut, H., Pascal, M., Vandentorren, S., Suzan, F.et al.The heat wave of August 2003: what happened?. Rev Prat 2004;54:12891297.Google ScholarPubMed
Megarbane, B., Resiere, D., Shabafrouz, K., Duthoit, G., Delahaye, A., Delerme, S.et al.Descriptive study of the patients admitted to an intensive care unit during the heat wave of August 2003 in France. Presse Med 2003;32:16901698.Google Scholar
Nakai, S., Itoh, T., Morimoto, T.Deaths from heat-stroke in Japan: 1968–1994. Int J Biometeorol 1999;43:124127.CrossRefGoogle ScholarPubMed
Naughton, M.P., Henderson, A., Mirabelli, M.C., Kaiser, R., Wilhelm, J.L., Kieszak, S.M.et al.Heat-related mortality during a 1999 heat wave in Chicago. Am J Prev Med 2002;22:221227.CrossRefGoogle ScholarPubMed
O'Neill, M.S., Zanobetti, A., Schwartz, J.Modifiers of the temperature and mortality association in seven US cities. Am J Epidemiol 2003;157:10741082.CrossRefGoogle Scholar
Pirard, P., Vandentorren, S., Pascal, M., Laaidi, K., Le Tertre, A., Cassadou, S.et al.Summary of the mortality impact assessment of the 2003 heat wave in France. Euro Surveill 2005;10:153156.CrossRefGoogle ScholarPubMed
Rooney, C., McMichael, A.J., Kovats, R.S., Coleman, M.P.Excess mortality in England and Wales, and in Greater London, during the 1995 heatwave. J Epidemiol Community Health 1998;52:482486.CrossRefGoogle ScholarPubMed
Saissy, M.Le coup de chaleur. Réanim Urgences 2000;9:498507.CrossRefGoogle Scholar
Semenza, J.C., McCullough, J.E., Flanders, W.D., McGeehin, M.A., Lumpkin, J.R.Excess hospital admissions during the July 1995 heat wave in Chicago. Am J Prev Med 1999;16:269277.CrossRefGoogle ScholarPubMed
Semenza, J.C., Rubin, C.H., Falter, K.H., Selanikio, J.D., Flanders, W.D., Howe, H.L.et al.Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med 1996;335:8490.CrossRefGoogle ScholarPubMed
StataCorp, Stata Statistical Software: Release 9. College Station, TX: StataCorp LP; 2005.Google Scholar
Valleron, A.J., Boumendil, A.Epidemiology and heat waves: analysis of the 2003 episode in France. C R Biol 2004;327:11251141.Google ScholarPubMed
Vanhems, P., Gambotti, L., Fabry, J.Excess rate of in-hospital death in Lyons, France, during the August 2003 heat wave. N Engl J Med 2003;349:20772078.CrossRefGoogle ScholarPubMed
Whitman, S., Good, G., Donoghue, E.R., Benbow, N., Shou, W., Mou, S.Mortality in Chicago attributed to the July 1995 heat wave. Am J Public Health 1997;87:15151518.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.