ArticlePloS one2026
Association between hypnotic medication use and in-hospital falls among older adults: A multicenter landmark analysis.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypnotics are frequently prescribed to hospitalized older adults, but comparative evidence on fall risk across hypnotic classes remains inconsistent, partly due to confounding by indication and inadequate consideration of time at risk during hospitalization.
methodsWe conducted a retrospective multicenter landmark analysis using administrative claims and electronic medical records from two acute-care hospitals in Japan (2018-2024). A day-7 landmark was defined, including patients aged ≥65 years who remained hospitalized and fall-free through hospital day 7. Sustained hypnotic exposure during hospital days 4-7 (≥2 days) was categorized as no sustained use, benzodiazepines/Z-drugs (BZ/Zs) alone, orexin receptor antagonists or ramelteon (ORA/Ram) alone, or combination therapy. The primary outcome was time to first in-hospital fall during hospital days 8-37. Cox proportional hazards models with multiple imputation were used. Competing-risk analyses and propensity score-matched comparisons between single-class users were conducted as sensitivity analyses.
resultsAmong 61,663 patients, 3,884 (6.3%) experienced an in-hospital fall after the landmark. Compared with no sustained hypnotic use, adjusted hazard ratios (HRs) for falls were 1.42 (95% CI, 1.24-1.64) for BZ/Zs, 1.46 (95% CI, 1.25-1.70) for ORA/Ram, and 1.42 (95% CI, 1.05-1.91) for combination therapy. Results were consistent in competing-risk analyses. In propensity score-matched analyses restricted to single-class users, fall risk did not differ significantly between BZ/Zs and ORA/Ram (adjusted HR, 0.98; 95% CI, 0.75-1.28).
conclusionsSustained hypnotic use during hospitalization was associated with a higher incidence of in-hospital falls among older adults. After adjustment for measured clinical factors and treatment selection, no significant difference in fall risk was observed between BZ/Zs and ORA/Ram.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.