“Stat” Medication Administration Predicts Hospital Discharge

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Objective This study describes the use of “stat” medications for inpatients in a large state psychiatric hospital system, and examines the relationship between receipt of a “stat” for agitation and subsequent hospital discharge. Methods Use of “stat” medications in 2005 was retrospectively determined using a database that contains diagnosis and prescription information from 17 state-run adult civil facilities. A logistic regression model explored the relationship between receipt of a “stat” order for intramuscular preparations of either antipsychotics or lorazepam within the first 30 days of hospitalization and likelihood of hospital discharge by 6 months. Results Among 7,202 patients who received antipsychotic medication in 2005, 3,240 (45%) also received a “stat” psychotropic medication during that year. Among 40,651 stat orders, 19,142 (47%) were for intramuscular antipsychotics or lorazepam presumably given for the treatment of agitation. Among 1,673 patients admitted in the first 6 months of 2005, 415 (25%) received at least one such “agitation stat.” The percent discharged at six months among “agitation stat” receivers was 39%, compared to 69% among those who did not receive an “agitation stat” (chi-square = 115, df = 1, P < .001). Regression analysis showed that receiving an “agitation stat” in the first 30 days of hospitalization was associated with a 37% lower likelihood of being discharged by 6 months after admission (odds ratio .63, 95% CI: .46-.86). Conclusions “Stat” medications are commonly used. The use of “agitation stat” medications can be used as a proxy for clinical stability and may prove to be a useful outcome measure for future pharmacoepidemiologic studies of comparative medication effectiveness.

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