Evidence map›Paper›PMID 41121962›Full record

ArticleJournal of the American Geriatrics Society2025

Association of Inpatient Prescribing of First-Generation Antihistamines With Delirium in Older Adults: A Cross-Sectional Study.

Alanna C Bridgman, Mohammad Arshad Imrit, Surain B Roberts, Mina Tadrous, Nathan M Stall, Michael Fralick, Jennifer Watt, Amol A Verma, Fahad Razak, Aaron M Drucker

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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

10 authors.

Alanna C BridgmanDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-5274-1527
Mohammad Arshad ImritLi Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Surain B RobertsLi Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Mina TadrousDepartment of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
Nathan M StallDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Michael FralickDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-2082-2445
Jennifer WattDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-5296-6013
Amol A VermaDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Fahad RazakDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Aaron M DruckerDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.

Funding

WCHAMSG Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario
6 · The paper itself

Abstract

backgroundSmall studies have reported associations between first-generation antihistamines and delirium. It is unclear whether first-generation antihistamines cause clinically important delirium among older adult inpatients.

objectiveTo estimate the association between inpatient physician prescribing of first-generation antihistamines and delirium among older general medicine inpatients.

methodsCross-sectional study using the GEMINI database of inpatient admissions between April 1, 2015, and March 31, 2022, across 17 hospitals in Ontario, Canada, among people aged 65 years and older. The main exposure was the proportion of attending physicians' admissions by quartile that included a first-generation antihistamine prescription. The primary outcome was inpatient delirium identified using a machine learning tool. We estimated the association between attending physicians' first-generation antihistamine prescribing rate and individual inpatients' risk of delirium using multivariable mixed-effects logistic regression.

resultsAmong 328,140 inpatient admissions to 755 physicians, 11,507 (3.5%) admissions included a first-generation antihistamine prescription. Physicians in the lowest quartile prescribed a first-generation antihistamine during 2.1% of admissions compared to 5.4% of physicians in the highest quartile. Delirium occurred in 32.3% of admissions to the lowest-prescribing quartile and 36.6% of the highest-prescribing quartile of physicians. In adjusted analyses, every 1% absolute increase in first-generation antihistamine prescribing was associated with 8% increased odds of delirium (aOR: 1.08, 95% CI: 1.05-1.10). Patients admitted to physicians in the highest quartile had 41% increased odds of delirium compared to the lowest quartile (aOR: 1.41, 95% CI: 1.28-1.56).

conclusionsOlder adults admitted to physicians who prescribe first-generation antihistamines more commonly were more likely to experience delirium in the hospital.

Indexed as

DeliriumHistamine AntagonistsInpatientsPractice Patterns, Physicians'AgedAged, 80 and overCross-Sectional StudiesFemaleHospitalizationHumansMaleOntarioHistamine Antagonistsdeliriumdrug safetyepidemiologygeriatricsinpatient medicine

Identifiers

PMID41121962
PMCPMC12645522

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LicenceCC BY-NC-ND
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Registered trials

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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.