New York City Children's Center, New York State Office of Mental Health, Brooklyn, NY, USA.
Psychiatr Q. 2013 Sep;84(3):343-9. doi: 10.1007/s11126-012-9250-2.
We assessed the predictors of clozapine initiation among youth 18 years and younger within a state psychiatric hospital. Administrative data (n = 358) were evaluated of inpatients from a long-term state child and adolescent psychiatric hospital. We investigated 25 background and clinical patient characteristics to determine which factors predicted clozapine initiation following the first 21 days of hospital admission. A Cox proportional model was used to evaluate factors that independently predicted the hazard rate of clozapine initiation. Emergency medication administration during the first 3 weeks of admission, which was more common among the clozapine (84.9 %) than control (61.7 %) patients (p < 0.001), was associated with a significantly increased probability of clozapine initiation (Hazard Ratio = 1.9, 95 % Confidence Interval = 1.2-3.1). Use of a mood stabilizer during the first 3 weeks of the inpatient was non-significantly related to an increased probability of clozapine initiation (Hazard Ratio = 1.7, 95 % Confidence Interval = 1.0-2.9). In this setting, emergency medication use predicts clozapine initiation suggesting that it may be used to treat patients with aggressive behavior.
我们评估了在一家州立精神病医院的 18 岁及以下青少年中开始氯氮平治疗的预测因素。对一家长期的州立儿童和青少年精神病医院的住院患者的行政数据（n=358）进行了评估。我们调查了 25 个背景和临床患者特征，以确定哪些因素在入院后前 21 天预测氯氮平的起始。使用 Cox 比例模型来评估独立预测氯氮平起始的风险率的因素。入院后前 3 周内的紧急药物治疗在氯氮平（84.9%）患者中比对照组（61.7%）更常见（p<0.001），与氯氮平起始的概率显著增加相关（风险比=1.9，95%置信区间=1.2-3.1）。在入院的前 3 周内使用情绪稳定剂与氯氮平起始概率的增加无显著相关性（风险比=1.7，95%置信区间=1.0-2.9）。在这种情况下，紧急药物的使用预测氯氮平的起始，表明它可能用于治疗有攻击性行为的患者。
