"Stat" medication administration predicts hospital discharge.
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.
Jaffe
Ari
A
Nathan S Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
Levine
Jerome
J
Citrome
Leslie
L
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011307:Drug Prescriptions; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007273:Injections, Intramuscular; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008140:Lorazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D008140:Lorazepam