Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10314/7192 https://doi.org/10.1007/s11096-022-01378-8 |
Resumo: | Background Although delirium is one of the most common adverse drug reactions observed in hospitalized older people, it remains underdiagnosed. Aim To estimate the prevalence of hospitalization of older people with potential medication-induced hyperactive delirium in the emergency department (ED); to identify the risk factors and the medicines frequently associated with the occurrence of the syndrome. Method A cross-sectional, retrospective study was performed with older people (age ≥ 60) admitted in 2018 to a Brazilian ED. The hospitalizations with suspected hyperactive delirium were screened with the aid of trigger-tools: International Code of Diseases-10th Revision, intra-hospital prescriptions of antipsychotics, and trigger-words related to the syndrome. A chart-review and medication review were developed to establish the causality assessment between adverse event and medicine. Logistic regression was used to determine risk factors for occurrence. Results Among the hospitalizations included, 67.5% (193/286) were screened by at least one trigger-tool. Of these, potential medication-induced hyperactive delirium was observed in 26.0% (50/193). The prevalence estimated in the ward was 17.5% (50/286). Opioids (31.9%), benzodiazepines (18.8%) and corticosteroids (10.6%) were the commonest medicines associated with delirium. Long-lived patients (p = 0.005), potentially inappropriate medicines (PIMs) (p = 0.025), and high weighted deliriogenic load (p = 0.014) were associated with potential medication-induced hyperactive delirium. Conclusion Approximately one in six hospitalizations of older people in the ED showed potential medication-induced hyperactive delirium. Data suggest PIMs and high weighted deliriogenic load, rather than polypharmacy or anticholinergic burden, are considered the most important characteristics of pharmacotherapy associated with avoidable hyperactive delirium among long-lived patients. |
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Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional studyAgedDeliriumDrug therapyEmergency servicehospitalRisk factorsBackground Although delirium is one of the most common adverse drug reactions observed in hospitalized older people, it remains underdiagnosed. Aim To estimate the prevalence of hospitalization of older people with potential medication-induced hyperactive delirium in the emergency department (ED); to identify the risk factors and the medicines frequently associated with the occurrence of the syndrome. Method A cross-sectional, retrospective study was performed with older people (age ≥ 60) admitted in 2018 to a Brazilian ED. The hospitalizations with suspected hyperactive delirium were screened with the aid of trigger-tools: International Code of Diseases-10th Revision, intra-hospital prescriptions of antipsychotics, and trigger-words related to the syndrome. A chart-review and medication review were developed to establish the causality assessment between adverse event and medicine. Logistic regression was used to determine risk factors for occurrence. Results Among the hospitalizations included, 67.5% (193/286) were screened by at least one trigger-tool. Of these, potential medication-induced hyperactive delirium was observed in 26.0% (50/193). The prevalence estimated in the ward was 17.5% (50/286). Opioids (31.9%), benzodiazepines (18.8%) and corticosteroids (10.6%) were the commonest medicines associated with delirium. Long-lived patients (p = 0.005), potentially inappropriate medicines (PIMs) (p = 0.025), and high weighted deliriogenic load (p = 0.014) were associated with potential medication-induced hyperactive delirium. Conclusion Approximately one in six hospitalizations of older people in the ED showed potential medication-induced hyperactive delirium. Data suggest PIMs and high weighted deliriogenic load, rather than polypharmacy or anticholinergic burden, are considered the most important characteristics of pharmacotherapy associated with avoidable hyperactive delirium among long-lived patients.2023-01-20T16:18:48Z2023-01-202022-01-27T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10314/7192http://hdl.handle.net/10314/7192https://doi.org/10.1007/s11096-022-01378-8eng35083658Raso, JúliaSantos, LincolnReis, DéboraFrangiotti, MaríliaZanetti, ArianeCapucho, HelaineHerdeiro, MariaRoque, FátimaPereira, LeonardoVarallo, Fabianainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-01-14T02:59:58Zoai:bdigital.ipg.pt:10314/7192Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T01:44:13.698347Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study |
title |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study |
spellingShingle |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study Raso, Júlia Aged Delirium Drug therapy Emergency service hospital Risk factors |
title_short |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study |
title_full |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study |
title_fullStr |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study |
title_full_unstemmed |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study |
title_sort |
Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study |
author |
Raso, Júlia |
author_facet |
Raso, Júlia Santos, Lincoln Reis, Débora Frangiotti, Marília Zanetti, Ariane Capucho, Helaine Herdeiro, Maria Roque, Fátima Pereira, Leonardo Varallo, Fabiana |
author_role |
author |
author2 |
Santos, Lincoln Reis, Débora Frangiotti, Marília Zanetti, Ariane Capucho, Helaine Herdeiro, Maria Roque, Fátima Pereira, Leonardo Varallo, Fabiana |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Raso, Júlia Santos, Lincoln Reis, Débora Frangiotti, Marília Zanetti, Ariane Capucho, Helaine Herdeiro, Maria Roque, Fátima Pereira, Leonardo Varallo, Fabiana |
dc.subject.por.fl_str_mv |
Aged Delirium Drug therapy Emergency service hospital Risk factors |
topic |
Aged Delirium Drug therapy Emergency service hospital Risk factors |
description |
Background Although delirium is one of the most common adverse drug reactions observed in hospitalized older people, it remains underdiagnosed. Aim To estimate the prevalence of hospitalization of older people with potential medication-induced hyperactive delirium in the emergency department (ED); to identify the risk factors and the medicines frequently associated with the occurrence of the syndrome. Method A cross-sectional, retrospective study was performed with older people (age ≥ 60) admitted in 2018 to a Brazilian ED. The hospitalizations with suspected hyperactive delirium were screened with the aid of trigger-tools: International Code of Diseases-10th Revision, intra-hospital prescriptions of antipsychotics, and trigger-words related to the syndrome. A chart-review and medication review were developed to establish the causality assessment between adverse event and medicine. Logistic regression was used to determine risk factors for occurrence. Results Among the hospitalizations included, 67.5% (193/286) were screened by at least one trigger-tool. Of these, potential medication-induced hyperactive delirium was observed in 26.0% (50/193). The prevalence estimated in the ward was 17.5% (50/286). Opioids (31.9%), benzodiazepines (18.8%) and corticosteroids (10.6%) were the commonest medicines associated with delirium. Long-lived patients (p = 0.005), potentially inappropriate medicines (PIMs) (p = 0.025), and high weighted deliriogenic load (p = 0.014) were associated with potential medication-induced hyperactive delirium. Conclusion Approximately one in six hospitalizations of older people in the ED showed potential medication-induced hyperactive delirium. Data suggest PIMs and high weighted deliriogenic load, rather than polypharmacy or anticholinergic burden, are considered the most important characteristics of pharmacotherapy associated with avoidable hyperactive delirium among long-lived patients. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-27T00:00:00Z 2023-01-20T16:18:48Z 2023-01-20 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10314/7192 http://hdl.handle.net/10314/7192 https://doi.org/10.1007/s11096-022-01378-8 |
url |
http://hdl.handle.net/10314/7192 https://doi.org/10.1007/s11096-022-01378-8 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
35083658 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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