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溴替唑仑在住院患者中的安全性。

Safety of brotizolam in hospitalized patients.

作者信息

Lavon Ophir, Bejel Shmuel

机构信息

Clinical Pharmacology and Toxicology Unit, Carmel Medical Center, Michal St. 7, 3436212, Haifa, Israel.

Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Eur J Clin Pharmacol. 2018 Jul;74(7):939-943. doi: 10.1007/s00228-018-2447-z. Epub 2018 Mar 22.

Abstract

PURPOSE

The objective of this study was to evaluate the safety of brotizolam in hospitalized patients.

METHODS

A single-center, comparative retrospective cohort analysis of patients hospitalized in internal medicine wards. Patients treated with brotizolam were compared to patients not treated with any benzodiazepines during hospitalization. Primary outcome was any of the following safety events: mechanical ventilation, delirium, and falls.

RESULTS

Six hundred patients were included after exclusion in the final analysis; 300 treated with brotizolam (treatment) and 300 not treated with any benzodiazepines (comparator). The brotizolam-treated patients were older with more comorbidities and psychotropic medications. After adjustment using multivariate logistic regression analysis with propensity score, the primary outcomes occurred at significantly higher rates in treated patients than in untreated patients (17 vs. 2 events; OR = 7.33). Any psychotropic medication administered during hospitalization was found by logistic regression to be the main independent risk factor for the studied safety outcomes while age, comorbidities, and the cause of hospitalization were not.

CONCLUSIONS

Treatment with brotizolam during hospitalization in internal medicine wards is linked to a higher risk of respiratory deterioration, delirium, and falls. Use of psychotropic medications during hospitalization is the main independent risk factor of safety outcomes. Further research is needed to fully evaluate the risks and benefits of sleep induction medications in hospitals.

摘要

目的

本研究的目的是评估住院患者使用溴替唑仑的安全性。

方法

对内科病房住院患者进行单中心、比较性回顾性队列分析。将使用溴替唑仑治疗的患者与住院期间未使用任何苯二氮䓬类药物的患者进行比较。主要结局是以下任何一种安全事件:机械通气、谵妄和跌倒。

结果

最终分析排除后纳入600例患者;300例接受溴替唑仑治疗(治疗组),300例未使用任何苯二氮䓬类药物(对照组)。接受溴替唑仑治疗的患者年龄更大,合并症和精神药物使用更多。在使用倾向评分的多因素逻辑回归分析进行调整后,治疗组患者的主要结局发生率显著高于未治疗组患者(17例 vs. 2例;OR = 7.33)。逻辑回归分析发现,住院期间使用的任何精神药物是所研究安全结局的主要独立危险因素,而年龄、合并症和住院原因则不是。

结论

内科病房住院期间使用溴替唑仑与呼吸功能恶化、谵妄和跌倒的较高风险相关。住院期间使用精神药物是安全结局的主要独立危险因素。需要进一步研究以全面评估医院中诱导睡眠药物的风险和益处。

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