Association between polypharmacy and the persistence of delirium: a retrospective cohort study.

IF 2.3 4区 医学 Q2 PSYCHIATRY BioPsychoSocial Medicine Pub Date : 2020-10-06 eCollection Date: 2020-01-01 DOI:10.1186/s13030-020-00199-3
Ken Kurisu, Daisuke Miyabe, Yoshiko Furukawa, Osamu Shibayama, Kazuhiro Yoshiuchi
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引用次数: 7

Abstract

Background: Although the association between polypharmacy and the occurrence of delirium has been well studied, the influence of polypharmacy on the persistence of delirium remains unclear. We aimed to explore the effect of polypharmacy on the persistence of delirium.

Methods: This retrospective cohort study was conducted at a tertiary hospital. The medical records of patients diagnosed with delirium who were referred to the Department of Psychosomatic Medicine were reviewed. Presentation with delirium on day 3 was set as the outcome in this study. We counted the number of drugs prescribed on the date of referral, excluding general infusion fluids, nutritional or electrolytic products, and psychotropics. To define polypharmacy, we developed a classification and regression tree (CART) model and drew a receiver operating characteristic (ROC) curve. The odds ratio (OR) of polypharmacy for the persistence of delirium on day 3 was calculated using a logistic regression model with the propensity score as a covariate.

Results: We reviewed the data of 113 patients. The CART model and ROC curve indicated an optimal polypharmacy cutoff of six drugs. Polypharmacy was significantly associated with the persistence of delirium both before [OR, 3.02; 95% confidence interval (CI), 1.39-6.81; P = 0.0062] and after (OR, 3.19; 95% CI, 1.32-8.03; P = 0.011) propensity score adjustment.

Conclusion: We discovered an association between polypharmacy and worsening courses of delirium and hypothesize that polypharmacy might be a prognostic factor for delirium.

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多药与谵妄持续之间的关系:一项回顾性队列研究。
背景:虽然多种药物与谵妄发生之间的关系已经得到了很好的研究,但多种药物对谵妄持续的影响尚不清楚。我们的目的是探讨多种药物对谵妄持续的影响。方法:回顾性队列研究在某三级医院进行。本文回顾了转介至心身内科诊断为谵妄的患者的医疗记录。本研究以第3天出现谵妄为结局。我们统计了转诊当日处方药物的数量,不包括普通输液、营养或电解质产品和精神药物。为了定义多药,我们建立了分类回归树(CART)模型,并绘制了受试者工作特征(ROC)曲线。采用logistic回归模型,以倾向评分作为协变量,计算多药治疗第3天谵妄持续的比值比(OR)。结果:我们回顾了113例患者的资料。CART模型和ROC曲线显示了6种药物的最佳多药截止点。多药治疗与谵妄持续时间显著相关[OR, 3.02;95%置信区间(CI), 1.39-6.81;P = 0.0062]后(OR, 3.19;95% ci, 1.32-8.03;P = 0.011)倾向得分调整。结论:我们发现了多种药物与谵妄病程恶化之间的联系,并推测多种药物可能是谵妄的预后因素之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.60
自引率
0.00%
发文量
23
审稿时长
18 weeks
期刊介绍: BioPsychoSocial Medicine is an open access, peer-reviewed online journal that encompasses all aspects of the interrelationships between the biological, psychological, social, and behavioral factors of health and illness. BioPsychoSocial Medicine is the official journal of the Japanese Society of Psychosomatic Medicine, and publishes research on psychosomatic disorders and diseases that are characterized by objective organic changes and/or functional changes that could be induced, progressed, aggravated, or exacerbated by psychological, social, and/or behavioral factors and their associated psychosomatic treatments.
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