Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Parenteral psychotropic use in hospitalised patients over 75 years with dementia (119052)

Jessica Young 1 2 , Triet Bui 1 2 , Vincent Ngian 1 2
  1. Department of Aged Care and Rehabilitation, Bankstown-Lidcombe Hospital, Sydney, NSW, Australia
  2. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia

Aims: To determine if parenteral sedation is associated with adverse outcomes in elderly hospitalised patients with dementia admitted under a geriatrician.

 

Methods: A retrospective cohort study was conducted on patients with dementia ≥ 75 years admitted under Geriatric Medicine at Bankstown-Lidcombe Hospital between 1 January and 31 December 2022. Data was extracted from South-Western Sydney Local Health District electronic medical records. Cox extended regression models, Cox proportional hazard regression and a modified Longitudinal Cumulative Dose1 method were used to evaluate outcomes including falls, pneumonia, acute kidney injury (AKI), inpatient mortality and readmission within 30 days.

 

Results: A total of 285 patients with dementia were included in the study. Of these, 59 patients (21%) received parenteral sedation during the hospital stay. During palliative care phase, 13 of 41 patients (31.7%) were given parenteral sedation. The doses used were in the low range of recommended dosage. Parenteral sedation in the non-palliative setting had a statistically significant association with AKI/dehydration (HRunadjusted=6.59, 95% CI: 3.06-14.2; p<0.001 and HRadjusted=9.98, 95% CI: 4.41-22.6; p<0.001) but not falls, pneumonia, inpatient death or readmission with 30 days.

 

Conclusions: In elderly inpatients with dementia, the risk of dehydration/AKI significantly increases during the risk period between the first dose and 3 days after the last dose of parenteral sedation. Parenteral sedation was not associated with falls, pneumonia, inpatient mortality or readmission. Cautious use of parenteral sedation in elderly patients with dementia is recommended until the relationship between parenteral sedation and outcomes is better understood with further research.

  1. Webster‐Clark M, Keil AP, Sanoff HK, Stürmer T, Westreich D, Lund JL. Introducing longitudinal cumulative dose to describe chemotherapy patterns over time: Case study of a colon cancer trial. Intl Journal of Cancer. 2021 Jul 15;149(2):394–402.