Department of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan.
Division of Rehabilitation & Community Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan.
Int J Geriatr Psychiatry. 2019 Oct;34(10):1465-1472. doi: 10.1002/gps.5155. Epub 2019 May 30.
To examine the association between benzodiazepines (BZDs) and Z-drugs treatment and risk of burn injury in elders.
We designed a nested case-control study. All subjects were aged 65 and older and enrolled in the National Health Insurance program in Taiwan, 2003 to 2012; 813 cases were identified with burn injury for the first time in their inpatient claims, and they were individually matched to 4879 controls based on age, gender, and index year. Benzodiazepines and Z-drugs usage (doses, duration, half-life) and the other covariates including comorbidities, health care utilization, and psychotropic medications used in the 365 days before index events were examined.
A significant increased risk of burn injury hospitalization in elders was observed among current Z-drugs users compared with nonusers (adjusted odds ratio [AOR] = 1.59, 95% confidence interval [CI] [1.23, 2.07]). BZDs at high (AOR = 1.81, 95% CI [1.12, 2.94] and medium dosage (AOR = 1.53, 95% CI [1.15, 2.04] and Z-drugs at medium dosage (AOR = 1.60, 95% CI [1.20, 2.12]) were all significantly increased the burn-related injury requiring hospitalization. Polypharmacy of anxiolytic and hypnotic BZDs, long- and short-acting BZDs, and more than one BZD with or without Z-drugs also increased the risk.
BZDs and Z-drugs prescriptions in elders may be associated with increased risk of burn injury hospitalization. When prescribing BZDs and Z-drugs, clinicians should exercise caution with the elderly to minimize risks.
研究苯二氮䓬类药物（BZDs）和 Z 类药物治疗与老年人烧伤风险的关系。
我们设计了一项嵌套病例对照研究。所有研究对象均为年龄在 65 岁及以上的人群，并于 2003 年至 2012 年纳入全民健康保险计划；813 例患者首次因烧伤在住院记录中被确诊，根据年龄、性别和索引年，对他们进行 1:6 个体匹配，共匹配到 4879 名对照。在索引事件发生前 365 天内，我们对苯二氮䓬类药物和 Z 类药物的使用情况（剂量、持续时间、半衰期）以及其他混杂因素、医疗保健利用和使用的精神药物进行了评估。
与非使用者相比，当前 Z 类药物使用者发生老年人烧伤住院的风险显著增加（调整后比值比 [AOR] = 1.59，95%置信区间 [CI] [1.23, 2.07]）。高剂量 BZDs（AOR = 1.81，95% CI [1.12, 2.94]）和中剂量 BZDs（AOR = 1.53，95% CI [1.15, 2.04]）以及中剂量 Z 类药物（AOR = 1.60，95% CI [1.20, 2.12]）的使用与烧伤相关的住院治疗风险显著增加。同时使用苯二氮䓬类药物和 Z 类药物、使用多种苯二氮䓬类药物、使用长/短效苯二氮䓬类药物和使用一种以上苯二氮䓬类药物或 Z 类药物均会增加风险。
BZDs 和 Z 类药物处方的使用与老年人烧伤住院风险增加有关。在为老年人开具 BZDs 和 Z 类药物处方时，临床医生应谨慎用药，以最大限度地降低风险。
