Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Northrop Grumman Corporation, Atlanta, Georgia.
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2020 Apr;58(4):526-535. doi: 10.1016/j.amepre.2019.11.017. Epub 2020 Feb 20.
Characterization of emergency department visits attributed to adverse events involving benzodiazepines can be used to guide preventive interventions. This study describes U.S. emergency department visits attributed to adverse events involving benzodiazepines by intent, patient characteristics, and clinical manifestations.
Data from the 2016-2017 National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project were analyzed in 2019 to calculate estimated annual numbers and rates of emergency department visits attributed to adverse events involving benzodiazepines, by intent of benzodiazepine use.
Based on 6,148 cases, there were an estimated 212,770 (95% CI=167,163, 258,377) emergency department visits annually attributed to adverse events involving benzodiazepines. More than half were visits involving nonmedical use of benzodiazepines (119,008; 55.9%, 95% CI=50.0%, 61.9%), one third were visits involving self-harm with benzodiazepines (64,721; 30.4%, 95% CI=25.6%, 35.2%), and a smaller proportion of visits involved therapeutic use of benzodiazepines (29,041; 13.6%, 95% CI=11.4%, 15.9%). The estimated population rate of visits was highest for nonmedical use of benzodiazepines by patients aged 15-34 years (7.4 visits per 10,000 people). Among visits involving nonmedical use of benzodiazepines, 54.8% (95% CI=49.8%, 59.8%) were made by patients aged 15-34 years, 82.7% (95% CI=80.1%, 85.4%) involved concurrent use of other substances (illicit drugs, alcohol, prescription opioids, and/or other pharmaceuticals), and 24.2% (95% CI=17.7%, 30.6%) involved cardiorespiratory arrest or unresponsiveness.
These findings support recommendations to assess for and address substance use disorder before initiating or continuing benzodiazepines and reinforce the need for validated self-harm risk assessment tools for clinicians.
对涉及苯二氮䓬类药物的不良事件导致的急诊科就诊情况进行特征描述，可用于指导预防干预措施。本研究描述了美国因意图使用苯二氮䓬类药物、患者特征和临床表现而导致的涉及苯二氮䓬类药物的不良事件所致急诊科就诊情况。
对 2019 年国家电子伤害监测系统-合作不良药物事件监测项目的 2016-2017 年数据进行分析，按苯二氮䓬类药物使用意图计算因涉及苯二氮䓬类药物的不良事件而导致的急诊科就诊的估计年数和就诊率。
基于 6148 例病例，估计每年有 212770 例（95%CI=167163，258377）因涉及苯二氮䓬类药物的不良事件而导致急诊科就诊。其中一半以上是涉及苯二氮䓬类药物非医疗使用的就诊（119008 例；55.9%，95%CI=50.0%，61.9%），三分之一是涉及苯二氮䓬类药物自我伤害的就诊（64721 例；30.4%，95%CI=25.6%，35.2%），而较小比例的就诊涉及苯二氮䓬类药物的治疗性使用（29041 例；13.6%，95%CI=11.4%，15.9%）。涉及苯二氮䓬类药物非医疗使用的就诊估计人群发生率最高的是 15-34 岁年龄段的患者（每 10000 人中有 7.4 次就诊）。在涉及苯二氮䓬类药物非医疗使用的就诊中，54.8%（95%CI=49.8%，59.8%）是由 15-34 岁的患者就诊，82.7%（95%CI=80.1%，85.4%）涉及同时使用其他物质（非法药物、酒精、处方类阿片类药物和/或其他药物），24.2%（95%CI=17.7%，30.6%）涉及心肺复苏或无反应。
这些发现支持在开始或继续使用苯二氮䓬类药物之前评估和处理物质使用障碍的建议，并强调需要为临床医生制定经过验证的自我伤害风险评估工具。
