Association of Benzodiazepine Prescription With Short-Term Prognosis in Elderly Patients Attended in Emergency Department: Results From the EDEN PROJECT.
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Ruiz-Ramos Jesus, Alquézar-Arbé Aitor, Juanes-Borrego Ana, González-Del-Castillo Juan, Jacob Javier, Burillo Guillermo, Aguiló Sira, Fernandez Cesáreo, Plaza-Díaz Adrián, Millán-Soria Javier, Jara-Torres Gema, López-Delmas Nieves, Muñoz-Triano Esperanza, Martín-Durán Cristina, Delgado-Sardina Violeta, Gallardo-Sánchez Blanca Andrea, Osorio-Quispe Ivet Gina, Real-López Antonio, Gordo-Remartinez Susana, González-Ferreira Lucía, Álvarez-Madrigal Alberto, Martínez-Ibarreta-Zorita Julia, Sánchez-Moreno María, Sanchez-Moreno Maite, Sánchez-Serrano Jesús Ángel, Hernando-Fernández Raquel, Turcios-Torres Jennifer, Ponte-Márquez Paola, Miró Òscar
Аннотация
METHODS: A retrospective analysis of the EDEN (Emergency Department Elderly in Need) cohort was conducted. This registry included all elderly patients attending in 52 Spanish EDs for any condition, between April 1st and 7th in 2019. Socio-demographic data, comorbidities, and medication were recorded by consulting the patient's electronic health records. The assessed outcomes consisted on new ED visit, hospitalization, and mortality at 30 days after the first ED visit, associated with the use of benzodiazepines at baseline in comparison with no prescription of benzodiazepines. Crude and adjusted logistic regression analyses including patient's comorbidities were performed. Two sensitivity analyses were performed considering concomitant prescription of other central nervous system depressants as well as direct discharge from the ED.
RESULTS: 25 557 patients were evaluated (mean age 78 [IQR: 71-84]). 7865 (30.8%) patients were taken benzodiazepines at admission. After adjustment for comorbidities and other central nervous system drugs, benzodiazepine prescription was associated with ED revisit [OR: 1.10 (95%CI: 1.03-1.18)]. Similar results were found in the sensitivity analysis, eliminating patients with central nervous depressors [OR: 1.11 (1.03-1.25)] and patients discharged to home [OR: 1.13 (1.04-1.23)]. No association was found between the use of these drugs and new hospitalizations [OR: 0.90 (0.77-1.05)] or mortality 30 days after discharge [OR: 1.01 (0.88-1.18)]. The results held for all three outcomes in the sensitivity analyses.
CONCLUSION: The use of benzodiazepines is a frequent phenomenon among the elderly population attended in the ED, being associated with an increased risk of new visits to the emergency room, but not with an increased risk of 30-day hospitalization or mortality.