Benzodiazepine prescription and length of hospital stay at a Japanese university hospital
Benzodiazepine prescription and length of hospital stay at a Japanese university hospital
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日本大学附属医院苯二氮卓类药物处方及住院时间
作者：
M. Nakao;Mikiya Sato;K. Nomura;E. Yano
背景在西方国家，卧床天数与苯二氮卓类药物处方（BDZ）之间的关系尚无定论，在日本也没有医院报告记录这一现象。方法2005年4月至2006年12月期间住院的21,489例成人患者（55.1%为男性，平均年龄59.9岁）纳入本研究。患者的年龄，性别，ICD-10诊断，处方配置文件，并在13个非精神科住院天数进行了评估，使用计算机订购系统。患者在住院期间规定的苯二氮卓类被定义为positive.ResultsOf总样本，19.9%被分配到苯二氮卓类（+）组。女性和老年是苯二氮卓类药物处方的重要相关因素。中位卧床天数为13天，BDZ的可能性随着卧床天数的增加而显著增加，即使在控制了年龄，性别和ICD-10诊断的影响之后。例如，当分析仅限于50床天或更长时间的患者，BDZ（32.7%）的百分比相当于从法国的报告。结论无论部门或疾病，患者在住院期间开苯二氮卓类药物往往有更多的床天在医院。本研究与既往西方研究之间BDZ患病率的差异可能归因于本研究中住院时间相对较短。由于经常报告在没有适当的适应症文件的情况下向住院患者开具BDZ处方，因此出于临床和经济原因，仔细监测苯二氮卓类处方的合理性非常重要。
BackgroundThe relationship between bed days and benzodiazepine prescription (BDZ) in Western countries is inconclusive, and no hospital-based report has documented this phenomenon in Japan. This study was done to assess the association between bed days and BDZ in a Japanese hospital.Methods21,489 adult patients (55.1% men, mean age 59.9 years old) hospitalized between April, 2005 and December, 2006 were enrolled in the study. Patient age, sex, ICD-10 diagnosis, prescription profile, and days of hospital stay were assessed in 13 non-psychiatric departments using a computer ordering system. Patients prescribed a benzodiazepine during hospitalization were defined as positive.ResultsOf the total sample, 19.9% were allocated to the benzodiazepine (+) group. Female sex and older age were significant factors associated with benzodiazepine prescription. The median number of bed days was 13, and the likelihood of BDZ significantly increased with the number of bed days, even after controlling for the effects of age, gender, and ICD-10 diagnosis. For example, when the analysis was limited to patients with 50 bed days or longer, the percentage of BDZ (32.7%) was equivalent to that of a report from France.ConclusionIrrespective of department or disease, patients prescribed benzodiazepine during their hospital stay tended to have a higher number of bed days in the hospital. The difference in the prevalence of BDZ between this study and previous Western studies might be attributed to the relatively short length of hospital stay in this study. Because BDZs are often reported to be prescribed to hospitalized patients without appropriate documentation for the indications for use, it is important to monitor the rational for prescriptions of benzodiazepine carefully, for both clinical and economical reasons.