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Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis

BACKGROUND: Delirium in patients with acute decompensated heart failure (ADHF) is associated with poor clinical outcomes. Although some medications have been reported as risk factors for delirium, their impact on patients with ADHF is still unclear. This study aimed to determine the association of s...

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Autores principales: Kawada, Kei, Fukuda, Hitoshi, Kubo, Toru, Ohta, Tsuyoshi, Ishida, Tomoaki, Morisawa, Shumpei, Kawazoe, Tetushi, Okamoto, Manami, Fujita, Hiroko, Jobu, Kohei, Morita, Yasuyo, Ueba, Tetsuya, Kitaoka, Hiroaki, Miyamura, Mitsuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8062069/
https://www.ncbi.nlm.nih.gov/pubmed/33886657
http://dx.doi.org/10.1371/journal.pone.0250372
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author Kawada, Kei
Fukuda, Hitoshi
Kubo, Toru
Ohta, Tsuyoshi
Ishida, Tomoaki
Morisawa, Shumpei
Kawazoe, Tetushi
Okamoto, Manami
Fujita, Hiroko
Jobu, Kohei
Morita, Yasuyo
Ueba, Tetsuya
Kitaoka, Hiroaki
Miyamura, Mitsuhiko
author_facet Kawada, Kei
Fukuda, Hitoshi
Kubo, Toru
Ohta, Tsuyoshi
Ishida, Tomoaki
Morisawa, Shumpei
Kawazoe, Tetushi
Okamoto, Manami
Fujita, Hiroko
Jobu, Kohei
Morita, Yasuyo
Ueba, Tetsuya
Kitaoka, Hiroaki
Miyamura, Mitsuhiko
author_sort Kawada, Kei
collection PubMed
description BACKGROUND: Delirium in patients with acute decompensated heart failure (ADHF) is associated with poor clinical outcomes. Although some medications have been reported as risk factors for delirium, their impact on patients with ADHF is still unclear. This study aimed to determine the association of specific medication use with delirium and their additive predictive value in models based on conventional risk factors. METHODS AND RESULTS: In this single-center, retrospective study, 650 patients treated for ADHF were included. Fifty-nine patients (9.1%) had delirium. In multivariate analysis, anxiolytic benzodiazepines [odds ratio (OR): 6.4, 95% confidence interval (CI): 2.8–15], mechanical ventilation or noninvasive positive pressure ventilation (OR: 6.0, 95% CI: 2.9–12), depression (OR: 3.2, 95% CI: 1.5–6.5), intensive care or high care unit admission (OR: 2.9, 95% CI: 1.5–5.6), male sex (OR: 2.0, 95% CI: 1–3.7), and age (OR: 1.1, 95% CI: 1–1.1) were independently associated with severe delirium. The predictive model that included anxiolytic benzodiazepines had a significantly better discriminatory ability for the incidence of severe delirium than the conventional model. CONCLUSIONS: The use of anxiolytic benzodiazepines was independently correlated with severe delirium, and their use in models based on conventional risk factors had an additive value for predicting delirium in patients with ADHF.
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spelling pubmed-80620692021-05-04 Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis Kawada, Kei Fukuda, Hitoshi Kubo, Toru Ohta, Tsuyoshi Ishida, Tomoaki Morisawa, Shumpei Kawazoe, Tetushi Okamoto, Manami Fujita, Hiroko Jobu, Kohei Morita, Yasuyo Ueba, Tetsuya Kitaoka, Hiroaki Miyamura, Mitsuhiko PLoS One Research Article BACKGROUND: Delirium in patients with acute decompensated heart failure (ADHF) is associated with poor clinical outcomes. Although some medications have been reported as risk factors for delirium, their impact on patients with ADHF is still unclear. This study aimed to determine the association of specific medication use with delirium and their additive predictive value in models based on conventional risk factors. METHODS AND RESULTS: In this single-center, retrospective study, 650 patients treated for ADHF were included. Fifty-nine patients (9.1%) had delirium. In multivariate analysis, anxiolytic benzodiazepines [odds ratio (OR): 6.4, 95% confidence interval (CI): 2.8–15], mechanical ventilation or noninvasive positive pressure ventilation (OR: 6.0, 95% CI: 2.9–12), depression (OR: 3.2, 95% CI: 1.5–6.5), intensive care or high care unit admission (OR: 2.9, 95% CI: 1.5–5.6), male sex (OR: 2.0, 95% CI: 1–3.7), and age (OR: 1.1, 95% CI: 1–1.1) were independently associated with severe delirium. The predictive model that included anxiolytic benzodiazepines had a significantly better discriminatory ability for the incidence of severe delirium than the conventional model. CONCLUSIONS: The use of anxiolytic benzodiazepines was independently correlated with severe delirium, and their use in models based on conventional risk factors had an additive value for predicting delirium in patients with ADHF. Public Library of Science 2021-04-22 /pmc/articles/PMC8062069/ /pubmed/33886657 http://dx.doi.org/10.1371/journal.pone.0250372 Text en © 2021 Kawada et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kawada, Kei
Fukuda, Hitoshi
Kubo, Toru
Ohta, Tsuyoshi
Ishida, Tomoaki
Morisawa, Shumpei
Kawazoe, Tetushi
Okamoto, Manami
Fujita, Hiroko
Jobu, Kohei
Morita, Yasuyo
Ueba, Tetsuya
Kitaoka, Hiroaki
Miyamura, Mitsuhiko
Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis
title Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis
title_full Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis
title_fullStr Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis
title_full_unstemmed Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis
title_short Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis
title_sort added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: a retrospective analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8062069/
https://www.ncbi.nlm.nih.gov/pubmed/33886657
http://dx.doi.org/10.1371/journal.pone.0250372
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