bensodiazepine 启动对医疗保险受益人死亡率的影响,急性缺血性中风后的死亡率
Madhav Sankaranarayanan1, Maria A Donahue2, Shuo Sun1
1Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
medRxiv : the preprint server for health sciences
|September 4, 2024
概括
在急性缺血性中风 (AIS) 后30天内开始使用二 (BZD) 显著增加了老年人的90天死亡风险,特别是76岁及以上的老年人和患有基线痴呆症的老年人.
科学领域:
- 老年医学 老年医学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 老年急性缺血性中风 (AIS) 幸存者经常接受二 (BZD) 尽管存在睡眠和呼吸系统抑郁等风险.
- 老年人更容易受到BZD的不良影响,原因是多种药物,代谢变化,并发症和中风后并发症.
研究的目的:
- 检查BZD在出院后30天内启动对AIS后老年医疗保险受益人的90天生存期的影响.
主要方法:
- 对20%的传统医疗保险受益者 (年龄66岁以上) 因AIS住院的样本进行分析 (2016年7月至2019年12月).
- 使用的医疗保险索赔数据 (MedPAR,TM,D部分) 与反向审查概率权重用于混.
- 主要暴露:退院后30天内开始BZD; 主要结局:90天死亡率.
主要成果:
- 在47,421名受益者中,1.74%的受益者在释放后启动了BZD;13.48%在90天内死亡.
- 开始BZD与每1000例26例的90天死亡风险 (95%CI:22,33) 相关.
- 在76岁以上 (RD:每1000人27-84人) 和患有基线痴呆症 (RD:每1000人87人) 的人群中,风险增加明显.
结论:
- 在AIS出院后30天内启动BZD显著增加了老年人 (76岁以上) 和痴呆症患者的90天死亡风险.
- 强调老年患者,特别是认知障碍患者对BZD不良影响的脆弱性.
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