Evidence map›Paper›PMID 28405945›Full record

SynthesisDrugs & aging2017

The Comparative Risk of Delirium with Different Opioids: A Systematic Review.

Lieke M Swart, Vera van der Zanden, Petra E Spies, Sophia E de Rooij, Barbara C van Munster

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Drugs & aging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 5 pooled it
9.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 5 syntheses or guidelines pooled it, 215 citations in OpenAlex.

  1. Pooled it
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  6. Trial
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  13. Article
  14. Chronic Pain and Opioids in the Elderly: Treating the Brain, Not Just the Body.International journal of environmental research and public health · 2026
    Review
  15. Article
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  18. Article
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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Lieke M SwartDepartment of Internal Medicine, Geriatrics Section, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. l.m.swart@amc.uva.nl.ORCID 0000-0002-0434-1203
Vera van der ZandenDepartment of Internal Medicine, Geriatrics Section, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Petra E SpiesGelre Hospitals, Department of Geriatric Medicine, Albert Schweitzerlaan 31, 7334 DZ, Apeldoorn, The Netherlands.
Sophia E de RooijDepartment of Internal Medicine, Geriatrics Section, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Barbara C van MunsterGelre Hospitals, Department of Geriatric Medicine, Albert Schweitzerlaan 31, 7334 DZ, Apeldoorn, The Netherlands.
Amsterdam UMC Location University of Amsterdam · NLUniversity Medical Center Groningen · NLGelre Hospitals · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of delirium from the use of various types of opioids in older patients.

methodsWe performed a search in MEDLINE by combining search terms on delirium and opioids. A specific search filter for use in geriatric medicine was used. Quality was scored according to the quality assessment for cohort studies of the Dutch Cochrane Institute.

resultsSix studies were included, all performed in surgical departments and all observational. No study was rated high quality, one was rated moderate quality, and five were rated low quality. Information about dose, route, and timing of administration of the opioid was frequently missing. Pain and other important risk factors of delirium were often not taken into account. Use of tramadol or meperidine was associated with an increased risk of delirium, whereas the use of morphine, fentanyl, oxycodone, and codeine were not, when compared with no opioid. Meperidine was also associated with an increased risk of delirium compared with other opioids, whereas tramadol was not. The risk of delirium appeared to be lower with hydromorphone or fentanyl, compared with other opioids. Numbers used for comparisons were small.

conclusionSome data suggest that meperidine may lead to a higher perioperative risk for delirium; however, high-quality studies that compare different opioids are lacking. Further comparative research is needed.

Indexed as

AgedAnalgesics, OpioidDeliriumHumansHydromorphoneMeperidineMorphineOxycodonePainPain MeasurementRisk FactorsTramadolAnalgesics, OpioidHydromorphoneMeperidineMorphineOxycodoneTramadol

Identifiers

PMID28405945
PMCPMC5427092
OpenAlexW2605561812

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.