Effects of anti-ulcer drugs on delirium in trauma patients

Rintaro Sogawa; Ayaka Matsuoka; Toru Murakawa-Hirachi; Nao Kikkawa; Masahiro Kamo; Shuko Tobita; Kota Shinada; Yoshito Mizoguchi; Akira Monji; Yuichiro Sakamoto; Chisato Shimanoe

doi:10.1016/j.genhosppsych.2022.12.007

Effects of anti-ulcer drugs on delirium in trauma patients

Gen Hosp Psychiatry. 2023 Jan-Feb:80:43-47. doi: 10.1016/j.genhosppsych.2022.12.007. Epub 2022 Dec 29.

Authors

Affiliations

¹ Department of Pharmacy, Saga University Hospital, Nabeshima, Saga 849-8501, Japan. Electronic address: sogawari@cc.saga-u.ac.jp.
² Department of Emergency and Critical Care Medicine, Saga University, Nabeshima, Saga 849-8501, Japan.
³ Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan. Electronic address: si5059@cc.saga-u.ac.jp.
⁴ Department of Pharmacy, Saga University Hospital, Nabeshima, Saga 849-8501, Japan. Electronic address: st7647@cc.saga-u.ac.jp.
⁵ Department of Pharmacy, Saga University Hospital, Nabeshima, Saga 849-8501, Japan. Electronic address: sw9317@cc.saga-u.ac.jp.
⁶ Department of Pharmacy, Saga University Hospital, Nabeshima, Saga 849-8501, Japan. Electronic address: sn5464@cc.saga-u.ac.jp.
⁷ Department of Emergency and Critical Care Medicine, Saga University, Nabeshima, Saga 849-8501, Japan. Electronic address: st9137@cc.saga-u.ac.jp.
⁸ Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan. Electronic address: ymizo@cc.saga-u.ac.jp.
⁹ Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan. Electronic address: amonji@hf.rim.or.jp.
¹⁰ Department of Pharmacy, Saga University Hospital, Nabeshima, Saga 849-8501, Japan. Electronic address: chisatos@cc.saga-u.ac.jp.

PMID: 36587448
DOI: 10.1016/j.genhosppsych.2022.12.007

Abstract

Objective: Histamine-2 receptor antagonists (H2RAs) may induce a higher risk of developing delirium than proton pump inhibitors (PPIs), but current evidence is insufficient. Therefore, this study aimed to investigate whether anti-ulcer drugs increase delirium risk.

Method: Data were obtained from the medical records of patients admitted to a hospital due to trauma. We compared the incidence of delirium in patients who received H2RAs and PPIs with that in patients who received no anti-ulcer drugs.

Results: A total of 150, 158, and 238 patients received H2RAs, PPIs, and no anti-ulcer drugs, respectively. Delirium incidence was significantly higher in patients who received H2RAs (34.0%) and PPIs (44.9%) than in those who did not receive anti-ulcer drugs (22.3%). Even after adjustment for possible confounding factors, the association between H2RAs and delirium remained (adjusted OR 1.78; 95% CI 1.04-3.05), but that between PPIs and delirium was attenuated (adjusted OR 1.25; 95% CI 0.71-2.23).

Conclusions: Our results show that H2RAs are associated with delirium risk. We replicated findings of a previous data-driven study. Clinicians need to consider the effect of delirium in anti-ulcer drug selection.

Keywords: Delirium; Histamine-2 receptor antagonist; Proton pump inhibitor.

MeSH terms

Anti-Ulcer Agents*
Delirium* / chemically induced
Delirium* / epidemiology
Histamine H2 Antagonists / adverse effects
Hospitalization
Humans
Proton Pump Inhibitors / adverse effects

Substances

Anti-Ulcer Agents
Histamine H2 Antagonists
Proton Pump Inhibitors