Although the association between polypharmacy and the occurrence of delirium has been well studied, the influence of polypharmacy on the persistence of delirium remains unclear. We aimed to explore the effect of polypharmacy on the persistence of delirium. This retrospective cohort study was conducted at a tertiary hospital. The medical records of patients diagnosed with delirium who were referred to the Department of Psychosomatic Medicine were reviewed. Presentation with delirium on day 3 was set as the outcome in this study. We counted the number of drugs prescribed on the date of referral, excluding general infusion fluids, nutritional or electrolytic products, and psychotropics. To define polypharmacy, we developed a classification and regression tree (CART) model and drew a receiver operating characteristic (ROC) curve. The odds ratio (OR) of polypharmacy for the persistence of delirium on day 3 was calculated using a logistic regression model with the propensity score as a covariate. We reviewed the data of 113 patients. The CART model and ROC curve indicated an optimal polypharmacy cutoff of six drugs. Polypharmacy was significantly associated with the persistence of delirium both before [OR, 3.02; 95% confidence interval (CI), 1.39–6.81; P = 0.0062] and after (OR, 3.19; 95% CI, 1.32–8.03; P = 0.011) propensity score adjustment. We discovered an association between polypharmacy and worsening courses of delirium and hypothesize that polypharmacy might be a prognostic factor for delirium.

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多种药物治疗与谵妄持续性之间的关联：一项回顾性队列研究

尽管已对多种药物与谵妄发生之间的关系进行了深入研究，但多种药物对谵妄持续性的影响仍不清楚。我们旨在探索多种药物对谵妄持续性的影响。这项回顾性队列研究是在一家三级医院进行的。对转诊至心身医学科的诊断为谵妄的患者的医疗记录进行了审查。将第 3 天出现谵妄的表现作为本研究的结果。我们计算了在转诊之日开出的药物数量，不包括一般输液、营养或电解产品以及精神药物。为了定义多药治疗，我们开发了分类和回归树 (CART) 模型并绘制了受试者工作特征 (ROC) 曲线。使用以倾向评分作为协变量的逻辑回归模型计算第 3 天持续谵妄的多种药物治疗的优势比 (OR)。我们回顾了 113 名患者的数据。CART 模型和 ROC 曲线表明六种药物的最佳多药截止值。在 [OR, 3.02; 95% 置信区间 (CI)，1.39–6.81；P = 0.0062] 和之后（OR，3.19；95% CI，1.32–8.03；P = 0.011）倾向评分调整。我们发现多种药物治疗与谵妄病程恶化之间存在关联，并假设多种药物治疗可能是谵妄的预后因素。我们回顾了 113 名患者的数据。CART 模型和 ROC 曲线表明六种药物的最佳多药截止值。在 [OR, 3.02; 95% 置信区间 (CI)，1.39–6.81；P = 0.0062] 和之后（OR，3.19；95% CI，1.32–8.03；P = 0.011）倾向评分调整。我们发现多种药物治疗与谵妄病程恶化之间存在关联，并假设多种药物治疗可能是谵妄的预后因素。我们回顾了 113 名患者的数据。CART 模型和 ROC 曲线表明六种药物的最佳多药截止值。在 [OR, 3.02; 95% 置信区间 (CI)，1.39–6.81；P = 0.0062] 和之后（OR，3.19；95% CI，1.32–8.03；P = 0.011）倾向评分调整。我们发现多种药物治疗与谵妄病程恶化之间存在关联，并假设多种药物治疗可能是谵妄的预后因素。