Benzodiazepine Utilization in Ischemic Stroke Survivors: Analyzing Initial Excess Supply and Longitudinal Trends
Stroke,
Год журнала:
2024,
Номер
55(11), С. 2694 - 2702
Опубликована: Окт. 17, 2024
BACKGROUND:
Benzodiazepines
are
commonly
prescribed
for
post-acute
ischemic
stroke
anxiety,
insomnia,
and
agitation.
While
guidelines
discourage
use
in
those
aged
≥65
years,
little
is
known
about
prescription
patterns
at
the
national
level.
METHODS:
We
analyzed
a
20%
sample
of
US
Medicare
claims
from
April
1,
2013,
to
September
30,
2021.
selected
beneficiaries
years
discharged
alive
following
an
acute
who
had
traditional
coverage
6
months’
prior
enrollment
Parts
A
(hospital
insurance),
B
(Medical
D
(drug
coverage).
excluded
with
benzodiazepine
prescriptions,
self-discharges,
or
discharge
skilled
nursing
facilities.
examined
demographics,
comorbidities,
first
days’
supply,
cumulative
incidences
fills
within
90
days
after
discharge,
geographic
yearly
trends.
RESULTS:
included
126
050
mean
age
78
(SD,
8);
54%
were
female
82%
White.
Within
days,
6127
(4.9%)
initiated
benzodiazepine.
Among
new
lorazepam
(40%)
alprazolam
(33%)
most
prescribed.
Most
(76%)
day’s
supply
over
7
55%
between
15
30
days.
Female
initiation
rates
higher
(5.5%
[95%
CI,
5.3–5.7])
than
male
(3.8%
3.6%–3.9%]).
Rates
highest
southeast
(5.1%
4.8%–5.3%])
lowest
midwest
(4.0%
3.8%–4.3%]),
modest
nationwide
decline
2013
2021
(cumulative
incidence
difference,
1.6%).
CONCLUSIONS:
Despite
gradual
2021,
we
noted
excessive
supplies
prescriptions
underscoring
need
improved
policies.
Язык: Английский
Examining the risk of delirium in patients hospitalized with COVID-19: Insights from the homeless population
Liam O’Neill,
Neale R. Chumbler
PLoS ONE,
Год журнала:
2025,
Номер
20(1), С. e0313242 - e0313242
Опубликована: Янв. 9, 2025
For
patients
hospitalized
with
COVID-19,
delirium
is
a
serious
and
under-recognized
complication,
people
experiencing
homelessness
(PEH)
may
be
at
greater
risk.
This
retrospective
cohort
study
compared
delirium-associated
risk
factors
clinical
outcomes
between
PEH
non-PEH.
used
patient
records
from
154
hospitals
discharged
2020-2021
the
Texas
Inpatient
Public
Use
Data
file.
Study
subjects
(n
=
878)
were
patients,
aged
18-69
years,
who
COVID-19
identified
as
homeless.
The
baseline
group
included
176,518)
years
not
Logistic
regression
models
to
identify
for
delirium.
Relevant
chronic
comorbidities,
substance
use
disorders,
traumatic
brain
injury
(TBI).
Seven
of
more
prevalent
among
baseline.
had
higher
rates
TBI,
alcohol,
cannabis,
opioid
disorders.
significantly
(10.6%
vs.
8.1%;
P<0.01).
However,
fewer
respiratory
complications,
including
pneumonia
(48.5%
81.9%;
P<0.001)
failure
(28.7%
61.9%;
P<0.001),
lower
in-hospital
mortality
(3.3%
9.5%;
P<0.001).
anti-viral
Remdesivir
protective
effect
against
(AOR
0.63;
CI:
0.60,
0.66).
Mean
hospital
length
stay
(LOS)
was
than
twice
long
delirious
non-delirious
(18.4
days
7.7
days;
Delirium
greatly
increased
3.8;
3.6,
4.0).
29)
died
present
in
half
(52%)
cases.
Hospitals
should
screen
adopt
nursing
protocols
prevent
reduce
its
severity.
Язык: Английский
Exploring the causal relationship between delirium and sarcopenia using bidirectional two-sample Mendelian randomization study
Progress in Neuro-Psychopharmacology and Biological Psychiatry,
Год журнала:
2025,
Номер
unknown, С. 111327 - 111327
Опубликована: Март 1, 2025
Язык: Английский
The Multidimensional Prognostic Index predicts incident delirium among hospitalized older patients with COVID-19: a multicenter prospective European study
European Geriatric Medicine,
Год журнала:
2024,
Номер
15(4), С. 961 - 969
Опубликована: Июнь 15, 2024
Abstract
Purpose
Incident
delirium
is
a
frequent
complication
among
hospitalized
older
people
with
COVID-19,
associated
increased
length
of
hospital
stay,
higher
morbidity
and
mortality
rates.
Although
preventable
early
detection,
systematic
assessment
methods
predictive
models
are
not
universally
defined,
thus
often
underrated.
In
this
study,
we
tested
the
role
Multidimensional
Prognostic
Index
(MPI),
prognostic
tool
based
on
Comprehensive
Geriatric
Assessment,
to
predict
risk
incident
delirium.
Methods
Hospitalized
patients
(≥
65
years)
COVID-19
infection
were
enrolled
(n
=
502)
from
ten
centers
across
Europe.
At
admission,
MPI
was
administered
all
two
already
validated
prediction
computed
(AWOL
risk-stratification
score
Martinez
model).
Delirium
occurrence
during
hospitalization
ascertained
using
4A’s
Test
(4AT).
Accuracy
other
assessed
through
logistic
regression
area
under
curve
(AUC).
Results
We
analyzed
293
without
at
admission.
Of
them
33
(11.3%)
developed
hospitalization.
Higher
admission
(higher
multidimensional
frailty)
also
adjusting
for
severity
(OR
12.72,
95%
CI
2.11–76.86
MPI-2
vs
MPI-1,
OR
33.44,
4.55–146.61
MPI-3
MPI-1).
The
showed
good
accuracy
in
predicting
(AUC
0.71)
superior
AWOL
tool,
0.63)
model
0.61)
(
p
<
0.0001
both
comparisons).
Conclusions
sensitive
identification
Язык: Английский
Exploring Antipsychotic Use for Delirium Management in Adults in Hospital, Sub-Acute Rehabilitation and Aged Care Settings: A Systematic Literature Review
Drugs & Aging,
Год журнала:
2024,
Номер
41(6), С. 455 - 486
Опубликована: Июнь 1, 2024
Язык: Английский
Delirium Related to COVID‐19 Infection
Опубликована: Ноя. 15, 2024
The
symptoms
of
delirium
are
often
mistaken
for
dementia
by
healthcare
workers.
Dementia
is
a
syndrome
that
progressively
impairs
thinking
and
memory,
affecting
person's
ability
to
function
independently
over
time.
While
can
occur
in
any
setting,
it
very
common
the
hospital.
It
affected
significant
portion
patients
even
before
onset
COVID-19
pandemic.
In
intensive
care
palliative
units,
has
been
shown
affect
70–80%
patients,
while
up
35%
older
adults
medical
surgical
units
experience
delirium.
general,
medications
used
treat
aimed
at
underlying
cause,
such
as
acetaminophen
suspected
pain.
However,
certain
symptoms,
behavioral
may
be
warranted.
likelihood
long-term
cognitive
impairment
following
an
stay
estimated
range
from
30%
80%
with
being
most
consistent
risk
factor.
Язык: Английский