title: Antipsychotic use in nursing home residents admitted with hip fracture.
abstract: OBJECTIVE
  To evaluate the association between receiving antipsychotics and the outcomes of a cohort of nursing home (NH) residents with and without presumed delirium after hip fracture.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  Eleven thousand one hundred nineteen nursing homes nationwide from January 1, 2000, to December 31, 2007.
  
  
  METHODS
  First-time NH admissions with hip fracture (n = 77,759).
  
  
  METHODS
  The Nursing Home Confusion Assessment Method was used to identify residents with no delirium, subsyndromal delirium, and full delirium. Propensity score reweighting was used, with analyses stratified according to delirium level.
  
  
  RESULTS
  In subjects with no delirium symptoms, approximately 5% (n = 3,250) received antipsychotic drugs. These individuals were less likely to be discharged home (odds ratio (OR) = 0.68, P < .001), had a higher likelihood of death before nursing home discharge (OR = 1.28, P = .03), stayed in nursing homes longer (β 2.83, P = .05), and had less functional improvement at discharge (β -0.47, P = .03). Receipt of antipsychotics in participants with mild delirium was associated with a lower likelihood of discharge home (OR = 0.74, P = .03).
  
  
  CONCLUSIONS
  In NH residents with hip fracture and no delirium symptoms, use of antipsychotics was associated with worse outcomes, with the exception of rehospitalization. No clear benefits were associated with antipsychotic use for those with presumed delirium.
authors.affiliation: Department of Health Services, Policy and Practice, Brown University, Providence, Rhode Island 02912, USA. hye-young_jung@brown.edu
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Jung
authors.forename: Marissa
authors.initials: M
authors.lastname: Meucci
authors.forename: Mark Aaron
authors.initials: MA
authors.lastname: Unruh
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
authors.forename: David
authors.initials: D
authors.lastname: Dosa
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003693:Delirium / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D009735:Nursing Homes; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents