Stolker J J, Heerdink E R, Pullen S E, Santman F W, Hekster Y A, Leufkens H G, Zitman F G
Department of Psychiatry, University Hospital Nijmegen, The Netherlands.
Gen Hosp Psychiatry. 1998 Nov;20(6):371-6. doi: 10.1016/s0163-8343(98)00048-6.
During a 3-month period, determinants of psychotropic drug utilization (sex, age, length of stay, reason for admission, disease severity) and data on psychotropic consumption (type of medication--antidepressants, benzodiazepines and antipsychotics--dosage and length of treatment) were retrospectively collected in a general intensive care unit of a Dutch university hospital. Daily exposure to psychotropics was standardized in number of Defined Daily Doses (DDD). Benzodiazepines were used by 35.8% of all patients (137) during their stay in the ICU whereas 17.5% of all patients used a neuroleptic agent. Antidepressants were hardly prescribed. High doses of benzodiazepines (9.9 DDDs) and low doses of antipsychotics (0.5 DDDs) were prescribed, which probably reflect the unusual nature of this critically ill group of patients compared with the reference group for DDD's. Clear patterns of determinants of psychotropic drug use in ICU patients were found and both benzodiazepines, antipsychotics and combined use of these agents could be associated with the determinants assessed. The time patterns we found in terms of length of stay give clues for further investigations in order to rationalize psychotropic drug use in the management of severely ill and complex patients.
在3个月的时间里，回顾性收集了荷兰一家大学医院普通重症监护病房中精神药物使用的决定因素（性别、年龄、住院时间、入院原因、疾病严重程度）以及精神药物消费数据（药物类型——抗抑郁药、苯二氮䓬类药物和抗精神病药——剂量和治疗时长）。精神药物的每日暴露量以限定日剂量（DDD）的数量进行标准化。在重症监护病房住院期间，35.8%的患者（137例）使用了苯二氮䓬类药物，而17.5%的患者使用了抗精神病药物。抗抑郁药很少被处方。苯二氮䓬类药物的高剂量（9.9 DDDs）和抗精神病药物的低剂量（0.5 DDDs）被处方，这可能反映了与DDD参考组相比，这一危重症患者群体的特殊性。在重症监护病房患者中发现了精神药物使用决定因素的明确模式，苯二氮䓬类药物、抗精神病药物以及这些药物的联合使用都可能与所评估的决定因素相关。我们在住院时间方面发现的时间模式为进一步研究提供了线索，以便在重症和复杂患者的管理中使精神药物的使用合理化。
