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Q In older persons, is use of diuretics, angiotensin converting enzyme (ACE) inhibitors, or non-steroidal anti-inflammatory drugs (NSAIDs) associated with hospital admission for lithium toxicity?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★☆☆☆ Emergency Medicine ★★★★★☆☆ Neurology ★★★★★☆☆ Geriatrics ★★★★★☆☆
METHODS
Design:
population based, nested, case control study with analysis of multiple linked healthcare databases over 10 years.
Setting:
Ontario, Canada.
Patients:
10 615 patients ⩾66 years of age (mean age 72 y, 62% women) who were receiving uninterrupted lithium treatment and resided in Ontario, Canada.
Assessment of risk factors:
use of diuretic (alone or in combination with another agent), ACE inhibitor, or prescription NSAID (including cyclooxygenase 2 inhibitors). Thiazide type and loop diuretics were examined separately.
Outcome:
hospital admission with diagnosis of lithium toxicity within 28 days …
Footnotes
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For correspondence: Dr D N Juurlink, University of Toronto, Toronto, Ontario, Canada. david.juurlink{at}ices.on.ca
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Sources of funding: Canadian Institutes of Health Research and Ontario Ministry of Health.