Association between polypharmacy and the persistence of delirium: a retrospective cohort study.
Association between polypharmacy and the persistence of delirium: a retrospective cohort study.
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DOI：
10.1186/s13030-020-00199-3
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发表时间：
2020
影响因子：
2.1
通讯作者：
Yoshiuchi K
中科院分区：
文献类型：
--
作者：
Kurisu K;Miyabe D;Furukawa Y;Shibayama O;Yoshiuchi K
尽管多药联用与精神分裂症的发生之间的联系已经被很好地研究，但多药联用对精神障碍持续性的影响仍不清楚。我们的目的是探讨多药联用对精神分裂症持续性的影响。这项回顾性队列研究是在一家三级医院进行的。对心身内科就诊的精神分裂症患者的病历进行复习。在这项研究中，第3天出现精神错乱作为结果。我们统计了转诊日开出的药物数量，不包括普通输液、营养或电解产品以及精神药物。为了定义多药房，我们开发了分类和回归树(CART)模型，并绘制了接受者工作特征(ROC)曲线。采用Logistic回归模型，以倾向性评分为协变量，计算综合用药对持续第3天精神障碍的优势比(OR)。我们回顾了113例患者的资料。CART模型和ROC曲线显示了6种药物的最佳分界值。在倾向性评分调整前[OR3.02；95%可信区间(CI)1.39-6.81；P = 0.0062]和调整后(OR3.19；95%CI，1.32-8.03；P = 0.011)，服用多种药物与精神障碍的持续性显著相关。我们发现多药联用与神志不清的病程恶化之间存在关联，并假设多药联用可能是神志不清的预后因素。
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. 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. 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. 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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影响因子：
4.7
作者：
Elsayem, Ahmed;Bush, Shirley H.;Bruera, Eduardo
通讯作者：
Bruera, Eduardo
影响因子：
3.5
作者：
Péus D;Newcomb N;Hofer S
通讯作者：
Hofer S
DOI：
10.1111/j.1532-5415.2009.02377.x
发表时间：
2009-08-01
影响因子：
6.3
作者：
Juliebo, Vibeke;Bjoro, Karen;Wyller, Torgeir Bruun
通讯作者：
Wyller, Torgeir Bruun
DOI：
10.1056/nejmcp1605501
发表时间：
2017-10-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
Marcantonio ER
通讯作者：
Marcantonio ER
影响因子：
4.1
作者：
Moorey HC;Zaidman S;Jackson TA
通讯作者：
Jackson TA