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66/100

✓ Peer-reviewed alzhub usefulness score 66 out of 100. Clinical safety

Topic: Risk, prevention and care in population studies

Plain-language summary

Background Inpatient falls are associated with significant morbidity and increased healthcare costs. Zolpidem has been reported to decrease balance and is associated with falls. Yet, it is a commonly used hypnotic agent in the inpatient setting. Zolpidem use in hospitalized patients may be a significant and potentially modifiable risk factor for falling. Objective To determine whether inpatients administered zolpidem are at greater risk of falling. Design Retrospective cohort study. Setting Adult non-intensive care unit (non-ICU) inpatients at a tertiary care center. Methods Adult inpatients who were prescribed zolpidem were identified. Electronic medical records were reviewed to capture demographics and other risk factors for falls. The fall rate was compared in those administered zolpidem versus those only prescribed zolpidem. Multivariate analyses were performed to determine whether zolpidem was independently associated with falls. Results The fall rate among patients who were prescribed and received zolpidem (n = 4962) was significantly greater than among patients who were prescribed but did not receive zolpidem (n = 11,358) (3.04% vs 0.71%; P < 0.001). Zolpidem use continued to remain significantly associated with increased fall risk after accounting for age, gender, insomnia, delirium status, dose of zolpidem, Charlson comorbidity index, Hendrich's fall risk score, length of hospital stay, presence of visual impairment, gait abnormalities, and dementia/cognitive impairment (adjusted odds ratio [OR] 4.37, 95% confidence interval [CI] = 3.34-5.76; P < 0.001). Additionally, patients taking zolpidem who experienced a fall did not differ from other hospitalized adult patients who fell in terms of age, opioids, antidepressants, sedative-antidepressants, antipsychotics, benzodiazepine, or antihistamine use. Conclusion Zolpidem use was a strong, independent, and potentially modifiable risk factor for inpatient falls.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Kolla, B. P., Lovely, J. K., Mansukhani, M. P., & Morgenthaler, T. I. (2013). Zolpidem is independently associated with increased risk of inpatient falls. Journal of hospital medicine. https://doi.org/10.1002/jhm.1985

Vancouver

Kolla BP, Lovely JK, Mansukhani MP, Morgenthaler TI. Zolpidem is independently associated with increased risk of inpatient falls. Journal of hospital medicine. 2013. doi:10.1002/jhm.1985. PMID: 23165956.

BibTeX

@article{kolla2013-23165956,
  author  = {Kolla, B. P. and Lovely, J. K. and Mansukhani, M. P. and Morgenthaler, T. I.},
  title   = {{Zolpidem is independently associated with increased risk of inpatient falls}},
  journal = {Journal of hospital medicine},
  year    = {2013},
  doi     = {10.1002/jhm.1985},
  pmid    = {23165956},
  url     = {https://doi.org/10.1002/jhm.1985}
}

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How to read this study

Design: this is a follow-up (cohort) study. People are observed over time and not assigned to anything, so an association can reflect other differences between groups. Look at how long follow-up lasted, how many dropped out, and whether the authors adjusted for age, education and other health conditions.
Size: the record lists 4,962 participants. Ask whether that is enough for the question, and who they were.
Effect: the record reports “3.04%; 0.71%”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded moderate. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Moderate means the abstract mentions a cohort, case-control or longitudinal design. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Background Inpatient falls are associated with significant morbidity and increased healthcare costs.
Zolpidem has been reported to decrease balance and is associated with falls.
Zolpidem use in hospitalized patients may be a significant and potentially modifiable risk factor for falling.
The fall rate was compared in those administered zolpidem versus those only prescribed zolpidem.
Multivariate analyses were performed to determine whether zolpidem was independently associated with falls.

Study details

Study designcohort study
Participants4,962
Effect size3.04%; 0.71%
Evidence strengthModerate

How this study scored 66/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 38 of the 58 points we could judge it on, which is 66 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of hospital medicine)
Journal's citation record	— / 4	No journal record from OpenAlex — left out of this score
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2013 — within 20 year(s) of the newest study here
Sample size	3 / 4	4,962 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	— / 7	No citation count (not found in OpenAlex) — left out of this score
Citations per year	— / 5	No citation count or no year — left out of this score
Impact for its field and year	— / 6	No field-weighted citation impact (OpenAlex has none yet) — left out of this score
Cited by studies here	— / 6	Not yet checked against this library's citation graph — left out of this score
Still being cited	— / 4	No yearly citation counts — left out of this score
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	— / 3	No institution listed in OpenAlex — left out of this score
Multicenter collaboration	— / 3	Institutions not listed — left out of this score
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 23165956)
Free to read	0 / 2	Behind a paywall — scores zero
Points	38 / 58	Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 38 of the 58 points we could judge it on is 66 out of 100.
Total	66 / 100	—

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