Evidence map›Paper›PMID 39774867›Full record

ArticleIntensive care medicine2025

Benzodiazepine and z-drug prescribing in critical care survivors and the risk of rehospitalisation or death due to falls/trauma and due to any cause: a retrospective matched cohort study using the UK Clinical Practice Research Datalink.

Elizabeth T Mansi, Christopher T Rentsch, Richard S Bourne, Annie Jeffery, Bruce Guthrie, Nazir I Lone

Abstract read
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Article in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Elizabeth T MansiUsher Institute, University of Edinburgh, Edinburgh, UK. liz.mansi@ed.ac.uk.ORCID 0000-0002-9625-3752
Christopher T RentschFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Richard S BourneDepartments of Pharmacy and Critical Care, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.ORCID 0000-0003-0893-525X
Annie JefferyDivision of Psychiatry, Epidemiology and Applied Clinical Research Department, University College London, London, UK.
Bruce GuthrieUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0003-4191-4880
Nazir I LoneUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0003-2707-2779

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBenzodiazepines and z-drugs are often prescribed to critical care survivors due to high prevalence of mental health problems and insomnia. However, their safety has not been studied in this population.

methodsRetrospective cohort study of 28,678 adult critical care survivors hospitalised in 2010 and 2018: 4844 prescribed benzodiazepines or z-drugs, matched to 23,834 unexposed survivors using UK Clinical Practice Research Datalink linked datasets. Multivariable stratified Cox regression was used to estimate the adjusted hazards ratio (adjHR) with 95% confidence intervals (CI) of community benzodiazepine/z-drug prescribing and falls/trauma-related events, as well as all-cause 30-day rehospitalisation or death. We performed subgroup analyses on patients without pre-critical care admission prescription of benzodiazepines/z-drugs ('treatment-naïve'), and sensitivity analyses excluding patients receiving palliative care after discharge.

resultsPrescription of benzodiazepines or z-drugs showed no conclusive evidence of increased risk of falls/trauma-related events in the whole cohort (adjHR 1.27; 95%CI 0.76-2.14) or in treatment-naïve individuals (adjHR 1.79; 95%CI 0.61-5.26), because estimates lacked precision due to low event rates. For all-cause rehospitalisation or death, benzodiazepines/z-drugs were associated with increased risk (whole cohort adjHR 1.24, 95%CI 1.14-1.36; treatment-naïve adjHR 1.66, 95%CI 1.49-1.86). However, after excluding patients treated for palliative care, the association persisted only in treatment-naïve individuals (whole cohort adjHR 1.08, 95%CI 0.98-1.19; treatment-naïve adjHR 1.42, 95%CI1.25-1.62).

conclusionsCommunity benzodiazepine and z-drug prescribing was associated with increased risk of all-cause, but not falls/trauma-related, rehospitalisations and deaths in critical care survivors who had not been prescribed these before hospitalisation. Clinicians should balance the possible benefits with the likely harms of prescribing these drugs in this potentially vulnerable patient group.

Indexed as

Accidental FallsBenzodiazepinesPatient ReadmissionSurvivorsWounds and InjuriesAdultAgedAged, 80 and overCohort StudiesCritical CareFemaleHumansHypnotics and SedativesMaleMiddle AgedRetrospective StudiesBenzodiazepinesHypnotics and SedativesBenzodiazepinesCritical careHypnotics and sedativesPharmacoepidemiology

Identifiers

PMID39774867

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.