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

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 coh...

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Autores principales: Kurisu, Ken, Miyabe, Daisuke, Furukawa, Yoshiko, Shibayama, Osamu, Yoshiuchi, Kazuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541288/
https://www.ncbi.nlm.nih.gov/pubmed/33042216
http://dx.doi.org/10.1186/s13030-020-00199-3
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author Kurisu, Ken
Miyabe, Daisuke
Furukawa, Yoshiko
Shibayama, Osamu
Yoshiuchi, Kazuhiro
author_facet Kurisu, Ken
Miyabe, Daisuke
Furukawa, Yoshiko
Shibayama, Osamu
Yoshiuchi, Kazuhiro
author_sort Kurisu, Ken
collection PubMed
description 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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spelling pubmed-75412882020-10-08 Association between polypharmacy and the persistence of delirium: a retrospective cohort study Kurisu, Ken Miyabe, Daisuke Furukawa, Yoshiko Shibayama, Osamu Yoshiuchi, Kazuhiro Biopsychosoc Med Research 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. BioMed Central 2020-10-06 /pmc/articles/PMC7541288/ /pubmed/33042216 http://dx.doi.org/10.1186/s13030-020-00199-3 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kurisu, Ken
Miyabe, Daisuke
Furukawa, Yoshiko
Shibayama, Osamu
Yoshiuchi, Kazuhiro
Association between polypharmacy and the persistence of delirium: a retrospective cohort study
title Association between polypharmacy and the persistence of delirium: a retrospective cohort study
title_full Association between polypharmacy and the persistence of delirium: a retrospective cohort study
title_fullStr Association between polypharmacy and the persistence of delirium: a retrospective cohort study
title_full_unstemmed Association between polypharmacy and the persistence of delirium: a retrospective cohort study
title_short Association between polypharmacy and the persistence of delirium: a retrospective cohort study
title_sort association between polypharmacy and the persistence of delirium: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541288/
https://www.ncbi.nlm.nih.gov/pubmed/33042216
http://dx.doi.org/10.1186/s13030-020-00199-3
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