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Patients who received H2 blockers as their first acid suppression therapy (n=73 335) served as the reference group before they received any PPI prescription (see online supplementary figure 1).Within the reference group, those who received a PPI prescription later (n=33 136) were considered to be in the PPI group from the date of their first PPI prescription until the end of follow-up.23 Time zero (T0) for primary cohort was defined as the first acid suppression therapy prescription date.Visual guides are also included to help you locate information needed for citations. Our comprehensive guide will teach you how to format your paper and create accurate citations.There are also numerous citation examples to help you learn to cite nearly anything!Results Over a median follow-up of 5.71 years (IQR 5.11–6.37), PPI use was associated with increased risk of death compared with H2 blockers use (HR 1.25, CI 1.23 to 1.28).Risk of death associated with PPI use was higher in analyses adjusted for high-dimensional propensity score (HR 1.16, CI 1.13 to 1.18), in two-stage residual inclusion estimation (HR 1.21, CI 1.16 to 1.26) and in 1:1 time-dependent propensity score-matched cohort (HR 1.34, CI 1.29 to 1.39).Tip of the month: Protect yourself from identity fraud at the gas pump. Contact your weights and measures authority with questions or concerns.

Evidence from several small cohort studies of older adults who were recently discharged from the hospital or institutionalised in long-term care facilities suggests inconsistently that PPI use may be associated with increased risk of 1 year mortality.19–22 Whether PPI use is associated with excess risk of death is not known and has not been examined in large epidemiological studies spanning a sufficiently long duration of follow-up.

We hypothesised that owing to the consistently observed associations between PPI use and risk of adverse health outcomes, PPI use is associated with excess risk of death, and that the risk of death would be more pronounced with increased duration of use.

We therefore used the Department of Veterans Affairs national databases to build a longitudinal cohort of incident users of acid suppression therapy, including PPI and histamine H2 receptor antagonists (H2 blockers), to examine the association between PPI use and risk of all-cause mortality and to determine whether risk of death is increased with prolonged duration of use.

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