ICU sedation, delirium & recovery
New and Persistent Sedative Prescriptions Among Older Adults Following a Critical Illness: A Population-Based Cohort Study
Authors' conclusion
One in 15 sedative-naive, older adult ICU survivors filled a new sedative within ≤ 7 days of discharge; more than one-half of these survivors filled persistent prescriptions.
Study context
- Population
- Sedative-naive ICU survivors aged ≥ 66 years, Ontario, Canada (2003–2019)
- Participants
- 250,428 survivors
- Outcome
- New sedative prescription
- Follow-up
- ≤ 7 days of discharge
Methodological detailsmultilevel logistic regression, multivariable proportional hazards model
- Multilevel logistic regression
- Multivariable proportional hazards model
Main finding
As reported in the abstract
New sedative prescription within ≤ 7 days of discharge
- Filled a new sedative prescription
- 15,277 (6.1%)
- Variation across hospitals
- 2% [95% CI, 1-3] to 44% [95% CI, 3-57]
- Discharge to long-term care facility, aOR
- 4.00; 95% CI, 3.72-4.31
- Inpatient geriatric consultation, aOR
- 1.95; 95% CI, 1.80-2.10
- Inpatient psychiatry consultation, aOR
- 2.76; 95% CI, 2.62-2.91
- Invasive ventilation, aOR
- 1.59; 95% CI, 1.53-1.66
- ICU LOS ≥ 7 days, aOR
- 1.50; 95% CI, 1.42-1.58
- Residual heterogeneity between hospitals, adjusted median OR (stronger association than Charlson Comorbidity Index or sepsis)
- 1.43; 95% CI, 1.35-1.49
Observational data: associations, not effects.
Further findings
Persistent sedative prescriptions (≤ 6 months)
- Filled persistent sedative prescriptions
- 8,458 (3.4%)
- Female, subdistribution HR
- 1.07; 95% CI, 1.02-1.13
- Pre-existing polypharmacy, subdistribution HR
- 0.88; 95% CI, 0.80-0.93
- Other associated factors similar to new sedative prescription
Original publication
New and Persistent Sedative Prescriptions Among Older Adults Following a Critical Illness: A Population-Based Cohort Study. Chest. Published 4 January 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →