Association between psychotropics use and occurrence of falls in hospitalized patients: A matched case-control study.

PCN reports : psychiatry and clinical neurosciences Pub Date : 2023-08-13 eCollection Date: 2023-09-01 DOI:10.1002/pcn5.133
Chihiro Morishita, Jiro Masuya, Yoshitaka Ishii, Tomoteru Seki, Ayaka Deguchi, Yoshio Iwata, Yu Tamada, Yota Fujimura, Mina Honyashiki, Kazuharu Harada, Masataka Taguri, Takeshi Inoue
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Abstract

Aim: Understanding the appropriate prescription of psychotropics for hospitalized patients in terms of preventing falls is an important issue. The aim of this study was to assess the associations between the occurrence of falls and the use of various individual psychotropics in hospitalized patients.

Methods: A retrospective matched case-control study was conducted on adult patients admitted to every department of Tokyo Medical University Hospital, with the outcome being in-hospital falls. A total of 447 hospitalized patients who had had in-hospital falls at some point in their hospitalization between January 2016 and December 2016 were included as cases. A total of 447 hospitalized patients who did not have in-hospital falls, and were individually matched to the cases by sex, age, and clinical department, were included as controls. All data were extracted from electronic medical records. Conditional logistic regression analyses were conducted to assess the association between the exposure to 16 psychotropic medications and the occurrence of in-hospital falls. The multivariable logistic regression model adjusted sex, age, clinical department, body mass index, fall risk score on the fall risk assessment measure, and use of psychotropic medications.

Results: The multivariable conditional logistic regression model showed a significant association between the use of risperidone (odds ratio [OR] = 3.730; 95% confidence interval [CI] = 1.229-11.325) and flunitrazepam (OR = 4.120; 95% CI = 1.105-15.364) and an increased OR of falls among hospitalized patients.

Conclusion: The use of risperidone and flunitrazepam were identified as risk factors for falls among hospitalized patients.

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住院患者使用精神药物与跌倒发生率之间的关系:一项匹配的病例对照研究
在预防跌倒方面,了解住院患者适当的精神药物处方是一个重要问题。本研究的目的是评估住院患者跌倒发生与使用各种精神药物之间的关系。对东京医科大学医院各科室收治的成年患者进行回顾性匹配病例对照研究,结果为院内跌倒。在2016年1月至2016年12月期间,共有447名住院患者在住院期间发生过院内跌倒。共纳入447例未发生院内跌倒的住院患者,并按性别、年龄和临床科室与病例单独匹配,作为对照。所有数据均取自电子病历。进行条件logistic回归分析以评估16种精神药物暴露与院内跌倒发生之间的关系。多变量logistic回归模型调整了性别、年龄、临床科室、体重指数、跌倒风险评估量表评分和精神药物使用情况。多变量条件logistic回归模型显示,利培酮的使用与死亡风险之间存在显著相关性(优势比[OR] = 3.730;95%可信区间[CI] = 1.229-11.325)和氟硝西泮(OR = 4.120;95% CI = 1.105-15.364),住院患者跌倒的OR增加。利培酮和氟硝西泮的使用被确定为住院患者跌倒的危险因素。
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