在住院患者中,与非GABAergic催眠药和二zepines相关的跌倒风险
Kazuhiro Shishida1, Waka Nishimura2, Yutaro Shimomura2
1Yokohama Municipal Citizen's Hospital, Department of Psychiatry, 1-1, Mitsuzawanishimachi, Kanagawa-ku, Yokohama, Kanagawa 221-0855, Japan.
General hospital psychiatry
|February 16, 2025
概括
非GABAergic催眠药ramelteon和suvorexant在住院患者的跌倒风险方面似乎是安全的. 然而,二和特拉佐与跌倒的风险增加有关,需要仔细监测.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 非GABAergic催眠药被认为与较老的药物相比,它们的跌倒风险更低.
- 支持这一假设的临床证据,特别是在住院患者中,仍然有限.
- 跌倒是医疗保健机构的一个重大问题,导致发病率和医疗保健成本增加.
研究的目的:
- 评估不同类型的催眠药物 (二胺,拉梅尔,苏沃雷克桑,特拉佐) 与住院患者中跌倒的发生率之间的关联.
- 确定接受催眠药物治疗的住院患者中跌倒的危险因素.
主要方法:
- 在2014年4月至2019年3月期间出院的20岁及以上的28029名住院患者的回顾性队列研究.
- 收集的数据包括跌倒发生率,催眠使用,人口统计,BMI,ADL得分和入院状态.
- 考克斯的比例危险模型被用来分析与跌倒相关的因素.
主要成果:
- 拉梅尔和苏沃雷克桑与跌倒风险增加无关 (aHR分别为0.78和0.44).
- 二西平 (aHR 2.17) 和特拉佐 (aHR 1.96) 与较高的跌倒发病率显著相关.
- 高龄,较低的BMI,轮椅依赖和非手术状态也被确定为跌倒的危险因素.
结论:
- 在住院患者中,ramelteon和suvorexant可能是关于跌倒风险的更安全的替代品.
- 二类药物和特拉佐的使用需要高度警,以减轻跌倒的风险.
- 进一步的研究应侧重于针对医院环境中催眠药物的使用量身定制的防摔策略.
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