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Article: Risk factors for sedation-related events during acute agitation management in the emergency department

TitleRisk factors for sedation-related events during acute agitation management in the emergency department
Authors
Issue Date2019
PublisherWiley, published in association with Society for Academic Emergency Medicine. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1553-2712
Citation
Academic Emergency Medicine, 2019, v. 26 n. 10, p. 1135-1143 How to Cite?
AbstractObjective: The objective was to describe the incidence, nature, and risk factors for adverse events (AEs) among patients who received parenteral sedation for acute agitation in an emergency department (ED) setting. Methods: We undertook a prospective observational study and a clinical trial of parenteral sedation for the management of acute agitation. We included agitated adult patients who required parenteral sedation from 2014 to 2017 in 12 Australian EDs, excluding those with incomplete information or aged under 18 years. The primary outcome was the number of patients who experienced at least one AE. Multivariable logistic regression was used to determine factors associated with AEs. Results: A total of 904 patients were included in the analyses (62.3% male; median age = 34 years, range = 18 to 95 years). Of these, 144 (15.9%) patients experienced at least one AE. The most common AEs were oxygen desaturation (7.4%), airway obstruction (3.6%), bradycardia (1.9%), hypotension (1.7%), and prolonged QTc interval (1.3%). No deaths or serious AEs were reported. The following factors had an increased adjusted odds ratio (OR) for experiencing an AE: age 65 years and older (OR = 2.8, 95% confidence interval [CI] = 1.2 to 7.2), more than one type of parenteral sedation administered within 60 minutes (OR = 2.1, 95% CI = 1.4 to 3.1), and alcohol intoxication (OR = 1.8, 95% CI = 1.2 to 2.6). Conclusions: Sedation‐related AEs are common, especially respiratory events. Elderly patients, sedation with multiple sedatives within 60 minutes, and alcohol intoxication increased the risk.
Persistent Identifierhttp://hdl.handle.net/10722/276093
ISSN
2023 Impact Factor: 3.4
2023 SCImago Journal Rankings: 1.279
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYap, CYL-
dc.contributor.authorTaylor, DM-
dc.contributor.authorKong, DCM-
dc.contributor.authorKnott, JC-
dc.contributor.authorTaylor, SE-
dc.contributor.authorGraudins, A-
dc.contributor.authorKeijzers, G-
dc.contributor.authorKulawickrama, S-
dc.contributor.authorThom, O-
dc.contributor.authorLawton, L-
dc.contributor.authorFuryk, J-
dc.contributor.authorFinucci, DP-
dc.contributor.authorHoldgate, A-
dc.contributor.authorWatkins, G-
dc.contributor.authorJordan, P-
dc.contributor.authorPhillips, GA-
dc.contributor.authorKarro, J-
dc.contributor.authorChan, EW-
dc.contributor.authorCastle, DJ-
dc.date.accessioned2019-09-10T02:55:48Z-
dc.date.available2019-09-10T02:55:48Z-
dc.date.issued2019-
dc.identifier.citationAcademic Emergency Medicine, 2019, v. 26 n. 10, p. 1135-1143-
dc.identifier.issn1069-6563-
dc.identifier.urihttp://hdl.handle.net/10722/276093-
dc.description.abstractObjective: The objective was to describe the incidence, nature, and risk factors for adverse events (AEs) among patients who received parenteral sedation for acute agitation in an emergency department (ED) setting. Methods: We undertook a prospective observational study and a clinical trial of parenteral sedation for the management of acute agitation. We included agitated adult patients who required parenteral sedation from 2014 to 2017 in 12 Australian EDs, excluding those with incomplete information or aged under 18 years. The primary outcome was the number of patients who experienced at least one AE. Multivariable logistic regression was used to determine factors associated with AEs. Results: A total of 904 patients were included in the analyses (62.3% male; median age = 34 years, range = 18 to 95 years). Of these, 144 (15.9%) patients experienced at least one AE. The most common AEs were oxygen desaturation (7.4%), airway obstruction (3.6%), bradycardia (1.9%), hypotension (1.7%), and prolonged QTc interval (1.3%). No deaths or serious AEs were reported. The following factors had an increased adjusted odds ratio (OR) for experiencing an AE: age 65 years and older (OR = 2.8, 95% confidence interval [CI] = 1.2 to 7.2), more than one type of parenteral sedation administered within 60 minutes (OR = 2.1, 95% CI = 1.4 to 3.1), and alcohol intoxication (OR = 1.8, 95% CI = 1.2 to 2.6). Conclusions: Sedation‐related AEs are common, especially respiratory events. Elderly patients, sedation with multiple sedatives within 60 minutes, and alcohol intoxication increased the risk.-
dc.languageeng-
dc.publisherWiley, published in association with Society for Academic Emergency Medicine. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1553-2712-
dc.relation.ispartofAcademic Emergency Medicine-
dc.titleRisk factors for sedation-related events during acute agitation management in the emergency department-
dc.typeArticle-
dc.identifier.emailChan, EW: ewchan@hku.hk-
dc.identifier.authorityChan, EW=rp01587-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/acem.13826-
dc.identifier.pmid31265756-
dc.identifier.scopuseid_2-s2.0-85069926812-
dc.identifier.hkuros303049-
dc.identifier.volume26-
dc.identifier.issue10-
dc.identifier.spage1135-
dc.identifier.epage1143-
dc.identifier.isiWOS:000480448100001-
dc.publisher.placeUnited States-
dc.identifier.issnl1069-6563-

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