Perioperative selective serotonin reuptake inhibitor administration is a marker of poor outcomes after surgery

Commentary on: Auerbach AD, Vittinghoff E, Maselli J, et al.. Perioperative use of selective serotonin reuptake inhibitors and risks for adverse outcomes of surgery. JAMA Intern Med 2013;173:1075–81. Context With a lifetime prevalence of 6–11%, depression is a common comorbidity in surgical patients. Owing to their high efficacy and safety, selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants.1 Some studies suggest that SSRIs may increase surgical bleeding. However, SSRI discontinuation may exacerbate psychiatric illness or precipitate withdrawal symptoms. Therefore, controversy exists over their perioperative management. Methods Auerbach and colleagues used administrative data from 530 416 patients in 375 US hospitals to determine the association between SSRI use and adverse surgical outcomes. They applied sensitivity analyses and propensity matching to control for the presence of unmeasured confounders. The findings are presented as OR and CI. Findings The authors found 72 540...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Heart failure, Stroke, Obesity (nutrition), Interventional cardiology, Drugs: musculoskeletal and joint diseases, Health education Source Type: research