To determine the net impact of PPIs on hospital mortality among inpatients, researchers designed a microsimulation model to estimate the risks of upper gastrointestinal bleeding, hospital-acquired pneumonia and Clostridium difficile infections following PPI therapy. They found:
1. New initiation of PPI therapy for inpatients led to an increase in hospital mortality in about 90 percent of simulated patients.
2. Continuing outpatient PPI therapy on admission led to net increase in hospital mortality in 79 percent of simulated patients.
3. Harm occurred in at least two-thirds of patients in all scenarios.
“For the majority of medical inpatients outside the [intensive care unit], use of PPIs likely leads to a net increase in hospital mortality. Even in patients at particularly high risk of [upper gastrointestinal bleeding], only those at the very lowest risk of [hospital-acquired pneumonia] and CDI should be considered for prophylactic PPI use,” concluded the study authors. “Continuation of outpatient PPIs may also increase expected hospital mortality. Apart from patients with active [upper gastrointestinal bleeding], use of PPIs in hospitalized patients should be discouraged.”
More articles on PPIs:
Prescription drug use skyrockets among US public: 3 things to know
Infection preventionists approve 11 C. diff prevention recommendations
Chronic PPI use may increase heart attack risk, study finds
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