Table 3. Results of the logistic regression analysis to evaluate the association between IV lorazepam use and mortality among patients admitted to a community-based hospital with and without cognitive impairment, 2017 through 2019.
The unadjusted association between IV lorazepam use and mortality was estimated by fitting a logistic regression model where the primary exposure of interest was IV lorazepam use and the primary outcome of interest was mortality. The adjusted association between IV lorazepam use and mortality was calculated by including additional variables in the logistic regression model that were selected to statistically control for other factors that may influence the magnitude of the unadjusted estimate of association. Covariables were selected by first fitting an adjusted model that included all significant variables from the univariate analysis (i.e., the full model), then fitting a series of reduced models -- each omitting one of the candidate variables -- and then evaluating the independent contribution of the omitted variable to the full model using a likelihood ratio test. Note: Although some of the unadjusted variables had significant ORs, after logistic regression analyses, they did not make the final multivariable model. *Statistically significant variables as 95% CI does not include 1. Abbreviations: IV: intravenous; CMI: case mix index; ICU: intensive care unit; OR: odds ratio; CI: confidence interval; NI: “not included” in the final multivariable model.
| Variables | Patients with cognitive impairment (n = 6,197) | Patients without cognitive impairment (n = 14,344) | ||
| Unadjusted OR (95% CI) | Adjusted OR (95% CI) | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | |
| IV Lorazepam | 6.18 (5.00, 7.65)* | 3.37 (2.52, 4.50)* | 22.41 (19.03, 26.40)* | 7.72 (6.09, 9.79)* |
| Age (years) | 1.00 (0.99, 1.02) | NI | 1.05 (1.04, 1.06)* | 1.05 (1.03, 1.06)* |
| Male | 1.38 (1.12, 1.69)* | NI | 1.14 (0.99, 1.33) | NI |
| CMI | 1.17 (1.13, 1.21)* | NI | 1.05 (1.01, 1.09)* | 0.90 (0.86, 0.95)* |
| ICU stay | 6.52 (5.17, 8.22)* | 3.09 (2.38, 4.01)* | 6.34 (5.40, 7.44)* | 3.35 (2.76, 4.08)* |
| Sepsis | 4.29 (3.43, 5.36)* | 2.39 (1.83, 3.13)* | 3.01 (2.41, 3.75)* | 2.27 (1.69, 3.04)* |
| Palliative care | 10.77 (8.65, 13.42)* | 4.72 (3.69, 6.04)* | 13.95 (11.79, 16.51)* | 5.35 (4.28, 6.68)* |
| Oral benzodiazepine | 0.39 (0.24, 0.63)* | 0.50 (0.30, 0.85)* | 0.36 (0.25, 0.54)* | 0.40 (0.26, 0.63)* |
| IV antipsychotics | 0.74 (0.53, 1.04) | NI | 1.65 (0.95, 2.87) | NI |
| Oral antipsychotics | 0.31 (0.20, 0.47)* | 0.28 (0.17, 0.44)* | 0.79 (0.45, 1.38) | NI |
| IV opioids | 3.87 (3.11, 4.82)* | 1.90 (1.42, 2.54)* | 2.18 (1.86, 2.54)* | NI |
| Oral opioids | 0.56 (0.41, 0.75)* | 0.56 (0.39, 0.80)* | 0.21 (0.17, 0.28)* | 0.41 (0.31, 0.55)* |
| Foley catheter used | 1.36 (1.05, 1.62)* | NI | 0.85 (0.70, 1.03) | NI |
| Alcohol related diagnosis | 0.75 (0.36, 1.53) | NI | - | - |