ICU管理を必要とする心臓血管外科手術患者における不眠症治療薬常用化因子の検討

抄録

This study aimed to determine factors that are associated with the continued use at hospital discharge of newly initiated insomnia medications in patients requiring intensive care unit (ICU) management after cardiovascular surgery and to elucidate indicators for pharmacist intervention in perioperative insomnia management. We retrospectively analyzed 94 patients admitted to the ICU following cardiovascular surgery between April 2023 and March 2024. Continued use was defined as the prescription at discharge of an insomnia medication newly initiated during hospitalization. Patient characteristics and insomnia medication-related variables were evaluated using multivariate logistic regression analysis. Thirty patients (31.9％) continued insomnia medication at discharge. After adjustment for insomnia severity, assessed by the cumulative number of insomnia medications administered during hospitalization, scheduled daily administration (odds ratio [OR], 19.98) and zolpidem use (OR, 26.77) were independently associated with continued use at discharge. These findings indicate that routine daily prescribing and zolpidem use are independently associated with persistent use ofinsomnia medications after hospitalization. Early identification of high-risk patients and proactive pharmacist involvement in modifying dosing schedules and optimizing medication selection based on clinical status may help prevent unnecessary continuation.