Opioids increase the risk of delirium in critically ill patients: A propensity score analysis

Shi，He Jie1,2,3; Zhang，Xue Ping1,2,3; Hai，Chao1,2,3; Shi，Wei1,2,3; Wang，Ping1,2,3; Hu，An Min1,2,3

2023-07-01

10.5414/CP204240

International Journal of Clinical Pharmacology and Therapeutics   Impact Factor & Quartile

0946-1965

Background: Medications are biologically plausible and potentially modifiable risk factors for delirium. Therapies for delirium might involve more specific strategies such as avoiding the use of deliriuminducing drugs to reduce the incidence of delirium. The association between opioid exposure within 24 hours prior to delirium assessment and the risk of delirium was studied. Materials and methods: Using three large databases, the MIMIC III v1.4, MIMIC-IV v0.4 and eICU Collaborative Research, we performed a multicenter, observational cohort study with two cohorts to estimate the relative risks of outcomes among patients administered opioids within 24 hours prior to delirium assessment. Propensity score matching was performed to generate a balanced 1 : 1 matched cohort and to identify potential prognostic factors. The outcomes included mortality, length of intensive care unit (ICU) stay, length of hospitalization, and odds of being discharged home. Results: Propensity matching successfully balanced the covariates for the 9,529 patients in each group. Opioid use was associated with a significantly higher risk for delirium than not using opioids (p < 0.001). Additionally, treatment with opioids was associated with higher mortality and a longer ICU stay (p < 0.001) than treatment without opioids. However, patients treated with opioids were more likely to be discharged home (p < 0.001). Conclusion: Opioids may be an independent risk factor for delirium in critically ill patients.

critically ill patients delirium opioids propensity score analysis

SCI

English

Others

Clinical agent research fund of Guangdong province[2022MZ12] ; Shenzhen Science and Technology Innovation Commission Fund Project[202205303002283]

Pharmacology & Pharmacy

Pharmacology & Pharmacy

WOS:000989468300001

DUSTRI-VERLAG DR KARL FEISTLE

2-s2.0-85164050697

Scopus

1.Department of Anesthesiology,Shenzhen People's Hospital,Shenzhen,China
2.The Second Clinical Medical College,Jinan University,Shenzhen,China
3.First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,China

Shi，He Jie,Zhang，Xue Ping,Hai，Chao,et al. Opioids increase the risk of delirium in critically ill patients: A propensity score analysis[J]. International Journal of Clinical Pharmacology and Therapeutics,2023,61(7):289-296.

Shi，He Jie,Zhang，Xue Ping,Hai，Chao,Shi，Wei,Wang，Ping,&Hu，An Min.(2023).Opioids increase the risk of delirium in critically ill patients: A propensity score analysis.International Journal of Clinical Pharmacology and Therapeutics,61(7),289-296.

Shi，He Jie,et al."Opioids increase the risk of delirium in critically ill patients: A propensity score analysis".International Journal of Clinical Pharmacology and Therapeutics 61.7(2023):289-296.