Table 2.
Association between PPI use and risk of death
| Association between PPI and death | Reference | PPI use | |
| PPI use vs H2 blockers use (n=3 49 312) |
Incident rate (95% CI) | 3.32 (3.25 to 3.39) | 4.67 (4.64 to 4.71) |
| Unadjusted HR (95% CI) | 1 | 1.46 (1.43 to 1.49) | |
| Adjusted HR (95% CI) | 1 | 1.25 (1.23 to 1.28) | |
| High-dimensional propensity score-adjusted model of new users of PPI vs H2 blockers (n=3 49 312) |
Incident rate (95% CI) | 3.32 (3.25 to 3.39) | 4.74 (4.70 to 4.77) |
| HR (95% CI) | 1 | 1.16 (1.13 to 1.18) | |
| Two-stage residual inclusion estimation model of new users of PPI vs H2 blockers (n=3 18 960) |
Incident rate (95% CI) | 3.32 (3.25 to 3.39) | 4.74 (4.70 to 4.77) |
| HR (95% CI) | 1 | 1.21 (1.16 to 1.26) | |
| Time-dependent propensity score-matched PPI vs H2 blockers (n=1 46 670) |
Incident rate (95% CI) | 3.32 (3.25 to 3.39) | 4.37 (4.30 to 4.44) |
| Unadjusted HR (95% CI) | 1 | 1.38 (1.34 to 1.42) | |
| Adjusted HR (95% CI) | 1 | 1.34 (1.29 to 1.39) | |
| PPI use vs no PPI (n=3 288 092) |
Incident rate (95% CI) | 3.64 (3.63 to 3.65) | 5.50 (5.47 to 5.53) |
| Unadjusted HR (95% CI) | 1 | 1.47 (1.46 to 1.48) | |
| Adjusted HR (95% CI) | 1 | 1.15 (1.14 to 1.15) | |
| PPI use vs no PPI or H2 blockers (n=2 886 879) |
Incident rate (95% CI) | 3.47 (3.46 to 3.48) | 5.50 (5.47 to 5.53) |
| Unadjusted HR (95% CI) | 1 | 1.53 (1.52 to 1.54) | |
| Adjusted HR (95% CI) | 1 | 1.23 (1.22 to 1.24) | |
| PPI vs H2 blockers in a cohort without GI conditions (n=2 14 521) |
Incident rate (95% CI) | 3.80 (3.71 to 3.89) | 5.39 (5.34 to 5.44) |
| Unadjusted HR (95% CI) | 1 | 1.47 (1.43 to 1.51) | |
| Adjusted HR (95% CI) | 1 | 1.24 (1.21 to 1.27) | |
| PPI vs no PPI in a cohort without GI conditions (n=2 790 697) |
Incident rate (95% CI) | 3.54 (3.53 to 3.55) | 5.89 (5.86 to 5.93) |
| Unadjusted HR (95% CI) | 1 | 1.62 (1.61 to 1.63) | |
| Adjusted HR (95% CI) | 1 | 1.19 (1.18 to 1.20) | |
| PPI vs no PPI or H2 blockers in a cohort without GI conditions (n=2 543 480) |
Incident rate (95% CI) | 3.45 (3.44 to 3.46) | 5.89 (5.86 to 5.93) |
| Unadjusted HR (95% CI) | 1 | 1.65 (1.64 to 1.67) | |
| Adjusted HR (95% CI) | 1 | 1.22 (1.21 to 1.23) | |
| PPI vs H2 blockers in a cohort without GI conditions except for GERD (n=311 115) |
Incident rate (95% CI) | 3.30 (3.23 to 3.37) | 4.51 (4.47 to 4.54) |
| Unadjusted HR (95% CI) | 1 | 1.42 (1.38 to 1.45) | |
| Adjusted HR (95% CI) | 1 | 1.24 (1.21 to 1.27) | |
| PPI vs no PPI in a cohort without GI conditions except for GERD (n=3 132 126) |
Incident rate (95% CI) | 3.59 (3.58 to 3.60) |
5.36 (5.34 to 5.39) |
| Unadjusted HR (95% CI) | 1 | 1.45 (1.44 to 1.46) | |
| Adjusted HR (95% CI) | 1 | 1.14 (1.13 to 1.14) | |
| PPI vs no PPI or H2 blockers in a cohort without GI conditions except for GERD (n=2 678 478) |
Incident rate (95% CI) | 3.44 (3.44 to 3.45) | 5.36 (5.34 to 5.39) |
| Unadjusted HR (95% CI) | 1 | 1.50 (1.49 to 1.51) | |
| Adjusted HR (95% CI) | 1 | 1.22 (1.21 to 1.22) | |
Incident rate as incident death in 100 person-years.
All models except time-dependent propensity score-matched and high-dimensional propensity score-adjusted models were time-dependent models. Effect of PPI was treated as time dependent and was defined as once patients used PPI, they were in PPI group during the remaining follow-up.
Adjusted model controlling for eGFR, age, race, gender, number of serum creatinine measurements, number of hospitalisations, diabetes mellitus, hypertension, cardiovascular disease, peripheral artery disease, cerebrovascular disease, chronic lung disease, hepatitis C, HIV, dementia, cancer, GERD, upper GI tract bleeding, ulcer disease, H. pylori infection, Barrett’s oesophagus, achalasia, stricture and oesophageal adenocarcinoma, unless used in analysis inclusion criteria.
GI conditions include upper GI tract bleeding, ulcer disease, H. pylori infection, Barrett’s oesophagus, achalasia, stricture and oesophageal adenocarcinoma.
GERD, gastro-oesophageal reflux disease; GI, gastrointestinal; PPI, proton pump inhibitor.