Sogawa Rintaro, Matsuoka Ayaka, Murakawa-Hirachi Toru, Kikkawa Nao, Kamo Masahiro, Tobita Shuko, Shinada Kota, Mizoguchi Yoshito, Monji Akira, Sakamoto Yuichiro, Shimanoe Chisato
Department of Pharmacy, Saga University Hospital, Nabeshima, Saga 849-8501, Japan.
Department of Emergency and Critical Care Medicine, Saga University, Nabeshima, Saga 849-8501, Japan.
Gen Hosp Psychiatry. 2023 Jan-Feb;80:43-47. doi: 10.1016/j.genhosppsych.2022.12.007. Epub 2022 Dec 29.
Histamine-2 receptor antagonists (H2RAs) may induce a higher risk of developing delirium than proton pump inhibitors (PPIs), but current evidence is insufficient. Therefore, this study aimed to investigate whether anti-ulcer drugs increase delirium risk.
Data were obtained from the medical records of patients admitted to a hospital due to trauma. We compared the incidence of delirium in patients who received H2RAs and PPIs with that in patients who received no anti-ulcer drugs.
A total of 150, 158, and 238 patients received H2RAs, PPIs, and no anti-ulcer drugs, respectively. Delirium incidence was significantly higher in patients who received H2RAs (34.0%) and PPIs (44.9%) than in those who did not receive anti-ulcer drugs (22.3%). Even after adjustment for possible confounding factors, the association between H2RAs and delirium remained (adjusted OR 1.78; 95% CI 1.04-3.05), but that between PPIs and delirium was attenuated (adjusted OR 1.25; 95% CI 0.71-2.23).
Our results show that H2RAs are associated with delirium risk. We replicated findings of a previous data-driven study. Clinicians need to consider the effect of delirium in anti-ulcer drug selection.
与质子泵抑制剂（PPI）相比，组胺-2受体拮抗剂（H2RA）可能会增加发生谵妄的风险，但目前证据不足。因此，本研究旨在调查抗溃疡药物是否会增加谵妄风险。
数据取自因创伤入院患者的病历。我们比较了接受H2RA和PPI的患者与未接受抗溃疡药物的患者的谵妄发生率。
分别有150、158和238例患者接受了H2RA、PPI和未接受抗溃疡药物治疗。接受H2RA（34.0%）和PPI（44.9%）的患者的谵妄发生率显著高于未接受抗溃疡药物治疗的患者（22.3%）。即使在对可能的混杂因素进行调整后，H2RA与谵妄之间的关联仍然存在（调整后的比值比为1.78；95%置信区间为1.04-3.05），但PPI与谵妄之间的关联减弱（调整后的比值比为1.25；95%置信区间为0.71-2.23）。
我们的结果表明，H2RA与谵妄风险相关。我们重复了先前一项数据驱动研究的结果。临床医生在选择抗溃疡药物时需要考虑谵妄的影响。
