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Preadmission use of antidepressants and risk of complications and death after colorectal cancer surgery: A nationwide population-based cohort study

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AIM: Few studies have evaluated how preadmission antidepressant use affects outcomes in colorectal cancer (CRC) patients undergoing surgery. Therefore, our aim is to examine if preadmission use of antidepressants increased the risk of complications and death in patients undergoing CRC surgery.

METHODS: We identified patients undergoing CRC surgery in Denmark from 2005 to 2012 through the Danish Colorectal Cancer Group Database. We identified prescriptions for antidepressants redeemed within one year prior to surgery and categorized users as current (≤90 days), former (91-365 days), and non-users. All patients were followed from surgery to 30 days thereafter or death. We calculated 30-day rates of complications, intensive care unit (ICU) admission, and mortality and compared these between users and non-users using logistic and Cox regression adjusting for potential confounders.

RESULTS: Of 27,374 patients, 8.9% were current users and 3.0% were former users. Antidepressant users were older, had more comorbidity, but similar cancer stage. Compared with non-users, current users had a higher risk of postoperative re-operation (adjusted odds ratio = 1.15 (95%CI 1.02;1.30)), medical complications (adjusted odds ratio = 1.41 (95%CI 1.25;1.60)), and increased ICU admission rate (adjusted hazard ratio = 1.32 (95%CI 1.21;1.45)). The 30-day mortality was 11.4% for current, 9.1% for former, and 6.2% for non-users (adjusted hazard ratio = 1.34 (95%CI 1.17;1.53) for current versus non-users).

CONCLUSION: Preadmission users of antidepressants had higher risk of complications and ICU admission, and higher 30-day mortality following CRC surgery than non-users. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalColorectal Disease
Pages (from-to)651-662
Number of pages12
Publication statusPublished - Jun 2019

    Research areas

  • Colorectal cancer, antidepressants, critical care, mortality, postoperative complications

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