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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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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. |
format | Online Article Text |
id | pubmed-8062069 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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