Gilbert Brian, Morales James R, Searcy Randi J, Johnson Donald W, Ferreira Jason A
1 Jackson Memorial Hospital, Miami, FL, USA.
2 UF Health Jacksonville, Jacksonville, FL, USA.
J Intensive Care Med. 2017 Feb;32(2):158-162. doi: 10.1177/0885066615622424. Epub 2016 Jul 7.
The purpose of this study was to identify risk factors associated with inappropriate continuation of neuroleptics postdischarge from the intensive care unit (ICU) and hospital.
A retrospective chart review was performed including all patients greater than 18 years of age who received neuroleptic medications in an ICU.
One hundred sixty-one patients were included during the 12- month study period. There were 85 (53%) patients discharged from the ICU with inappropriate continuation of a neuroleptic medication. There were 54 (34%) patients discharged from the hospital with inappropriate continuation of a neuroleptic medication. Patients were more likely to be discharged from the ICU with an inappropriate neuroleptic if they were prescribed multiple neuroleptics ( P = .02), did not have a urine drug screen collected at admission ( P = .023), or if trazodone was utilized in their therapy ( P = .004). Patients were more likely to be discharged from the hospital with a neuroleptic if they had multiple neuroleptic orders ( P = .0001) or if trazodone was utilized in their therapy ( P = .0023).
Risk factors associated with the continuation of inappropriate neuroleptic medications upon discharge from the ICU or the hospital include multiple neuroleptic medications prescribed, the lack of a urine drug screen upon admission, and the utilization of trazodone.
本研究旨在确定与重症监护病房（ICU）和医院出院后不适当继续使用抗精神病药物相关的风险因素。
进行了一项回顾性病历审查，纳入了所有在ICU接受抗精神病药物治疗的18岁以上患者。
在为期12个月的研究期间，共纳入161例患者。有85例（53%）患者从ICU出院时抗精神病药物使用不当。有54例（34%）患者出院时抗精神病药物使用不当。如果患者被开具多种抗精神病药物（P = 0.02）、入院时未进行尿液药物筛查（P = 0.023）或治疗中使用了曲唑酮（P = 0.004），则更有可能从ICU出院时抗精神病药物使用不当。如果患者有多个抗精神病药物医嘱（P = 0.0001）或治疗中使用了曲唑酮（P = 0.0023），则更有可能出院时继续使用抗精神病药物。
与从ICU或医院出院后继续不适当使用抗精神病药物相关的风险因素包括开具多种抗精神病药物、入院时未进行尿液药物筛查以及使用曲唑酮。
