Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis.

Abstract

BACKGROUND:

Delirium in patients with acute decompensated heart failure (ADHF) is associated with poor clinical outcomes. Although some medications have been reported as risk factors for delirium, their impact on patients with ADHF is still unclear. This study aimed to determine the association of specific medication use with delirium and their additive predictive value in models based on conventional risk factors.

METHODS AND RESULTS:

In this single-center, retrospective study, 650 patients treated for ADHF were included. Fifty-nine patients (9.1%) had delirium. In multivariate analysis, anxiolytic benzodiazepines [odds ratio (OR): 6.4, 95% confidence interval (CI): 2.8-15], mechanical ventilation or noninvasive positive pressure ventilation (OR: 6.0, 95% CI: 2.9-12), depression (OR: 3.2, 95% CI: 1.5-6.5), intensive care or high care unit admission (OR: 2.9, 95% CI: 1.5-5.6), male sex (OR: 2.0, 95% CI: 1-3.7), and age (OR: 1.1, 95% CI: 1-1.1) were independently associated with severe delirium. The predictive model that included anxiolytic benzodiazepines had a significantly better discriminatory ability for the incidence of severe delirium than the conventional model.

CONCLUSIONS:

The use of anxiolytic benzodiazepines was independently correlated with severe delirium, and their use in models based on conventional risk factors had an additive value for predicting delirium in patients with ADHF.

• Authors: Kei Kawada, Hitoshi Fukuda, Toru Kubo, Tsuyoshi Ohta, Tomoaki Ishida, Shumpei Morisawa, Tetushi Kawazoe, Manami Okamoto, Hiroko Fujita, Kohei Jobu, Yasuyo Morita, Tetsuya Ueba, Hiroaki Kitaoka, Mitsuhiko Miyamura
• Journal: PloS one (PLoS One) Vol. 16 Issue 4 Pg. e0250372 ( 2021) ISSN: 1932-6203 [Electronic] United States
• PMID: 33886657 (Publication Type: Journal Article)

Chemical References

• Anti-Anxiety Agents
• Benzodiazepines

Topics

• Acute Disease
• Age Factors
• Aged
• Aged, 80 and over
• Anti-Anxiety Agents (therapeutic use)
• Benzodiazepines (therapeutic use)
• Critical Care (methods)
• Delirium (drug therapy, epidemiology, etiology)
• Female
• Heart Failure (complications)
• Humans
• Incidence
• Male
• Middle Aged
• Patient Admission
• Respiration, Artificial (adverse effects)
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Sex Factors
• Treatment Outcome