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노인 입원환자에서 Delirium Drug Scale과 섬망 발생의 연관성 분석

Association between the Delirium Drug Scale and the Occurrence of Delirium in Hospitalized Older Patients

병원약사회지 2020년 37권 3호 p.317 ~ 329
김건희, 박가영, 전수정, 이정화, 이은숙, 김광일, 김은경,
소속 상세정보
김건희 ( Kim Keon-Hee ) - Seoul National University Bundang Hospital Department of Pharmacy
박가영 ( Park Ka-Young ) - Seoul National University Bundang Hospital Department of Pharmacy
전수정 ( Jeon Su-Jeong ) - Seoul National University Bundang Hospital Department of Pharmacy
이정화 ( Lee Jung-Hwa ) - Seoul National University Bundang Hospital Department of Pharmacy
이은숙 ( Lee Eun-Sook ) - Seoul National University Bundang Hospital Department of Pharmacy
김광일 ( Kim Kwang-Il ) - Seoul National University Bundang Hospital Department of Internal Medicine
김은경 ( Lee Euni ) - Seoul National University College of Pharmacy

Abstract


Background : Drugs are one of the major causes of delirium in elderly patients. As drug-associated delirium is usually reversible, evaluating the drug burden is clinically important in terms of delirium prevention. The Delirium Drug Scale (DDS) is a quantification tool developed to assess the impact of drugs on delirium in elderly patients. This study aimed to investigate the association between the scores and the occurrence of delirium in Korean elderly hospitalized patients.
Methods : We retrospectively reviewed the electronic medical records of patients who were admitted to a tertiary university hospital from January to December 2017, and underwent Comprehensive Geriatric Assessment. Lists of medications taken by the patients at the time of admission were collected and the occurrence of delirium within two days after admission was identified. The DDS score of each patient was calculated based on the collected medication data. The relationship between DDS scores and delirium occurrence was analyzed using logistic regression.

Results : A total of 452 patients were included in the study. The mean age of the patients was 82.0 ± 7.2 years. Delirium was detected in 54 patients (11.9%) and 258 patients (57.1%) were exposed to one or more drugs known to be associated with delirium. The unadjusted odds ratio (OR) for the DDS score was 2.02 (95% confidence interval [CI]:1.66; 2.46). In the multivariable analysis, a history of delirium, polypharmacy, infection, dementia, and age were significantly associated with delirium. When the confounding variables were adjusted, DDS scores were associated with the occurrence of delirium with an OR of 2.15 (95% CI: 1.69; 2.73).

Conclusion : DDS scores were associated with delirium occurrence among hospitalized older patients in Korea. The DDS can be considered an objective index when providing medication review services as part of a delirium prevention practice.

키워드

Delirium; Geriatric; Drug-induced; Risk factors; Delirium Drug Scale

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