Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, United States of America; University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, United States of America; Tottori University Faculty of Medicine, Department of Neuropsychiatry, Yonago, Tottori, Japan.
University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, United States of America.
J Psychosom Res. 2023 May;168:111212. doi: 10.1016/j.jpsychores.2023.111212. Epub 2023 Mar 12.
To investigate the relationship between history of anti-inflammatory medication use and delirium risk, as well as long-term mortality.
In this retrospective cohort study, subjects recruited between January 2016 and March 2020 were analyzed. Information about anti-inflammatory medication use history including aspirin, NSAIDs, glucosamine, and other anti-inflammatory drugs, was collected. Logistic regression analysis investigated the relationship between anti-inflammatory medications and delirium. Log-rank analysis and cox proportional hazards model investigated the relationship between anti-inflammatory medications and one-year mortality.
The data from 1274 subjects were analyzed. The prevalence of delirium was significantly lower in subjects with NSAIDs usage (23.0%) than in those without NSAIDs usage (35.0%) (p < 0.001). Logistic regression analysis controlling for age, sex, dementia status, and hospitalization department showed that the risk of delirium tended to be reduced by a history of NSAIDs use (OR, 0.76 [95% CI, 0.55 to 1.03]). The one-year mortality in the subjects with NSAIDs (survival rate, 0.879 [95% CI, 0.845 to 0.906]) was significantly lower than in the subjects without NSAIDs (survival rate, 0.776 [95% CI, 0.746 to 0.803]) (p < 0.001). A history of NSAIDs use associated with the decreased risk of one-year mortality even after adjustment for age, sex, Charlson Comorbidity Index, delirium status, and hospitalization department (HR, 0.70 [95% CI, 0.51 to 0.96]).
This study suggested that NSAIDs usage was associated with decreased delirium prevalence and lower one-year mortality. The potential benefit of NSAIDs on delirium risk and mortality were shown.
探讨抗炎药物使用史与谵妄风险以及长期死亡率之间的关系。
在这项回顾性队列研究中，对 2016 年 1 月至 2020 年 3 月期间招募的受试者进行了分析。收集了有关抗炎药物使用史的信息，包括阿司匹林、非甾体抗炎药、氨基葡萄糖和其他抗炎药物。使用逻辑回归分析研究了抗炎药物与谵妄之间的关系。使用对数秩检验和 Cox 比例风险模型研究了抗炎药物与一年死亡率之间的关系。
对 1274 名受试者的数据进行了分析。使用非甾体抗炎药的受试者谵妄发生率（23.0%）明显低于未使用非甾体抗炎药的受试者（35.0%）（p<0.001）。在控制年龄、性别、痴呆状态和住院科室后，逻辑回归分析显示，使用非甾体抗炎药的患者谵妄风险有降低的趋势（OR，0.76 [95%CI，0.55 至 1.03]）。使用非甾体抗炎药的受试者（1 年生存率为 0.879 [95%CI，0.845 至 0.906]）的 1 年死亡率明显低于未使用非甾体抗炎药的受试者（1 年生存率为 0.776 [95%CI，0.746 至 0.803]）（p<0.001）。即使在校正年龄、性别、Charlson 合并症指数、谵妄状态和住院科室后，使用非甾体抗炎药与降低 1 年死亡率相关（HR，0.70 [95%CI，0.51 至 0.96]）。
本研究表明，非甾体抗炎药的使用与谵妄发生率降低和 1 年死亡率降低有关。表明了非甾体抗炎药在谵妄风险和死亡率方面的潜在获益。
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