ArticleJournal of the American Geriatrics Society2021
Kidney Function Modifies the Effect of Intraoperative Opioid Dosage on Postoperative Delirium.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- The use of peripheral nerve block decrease incidence of postoperative cognitive dysfunction following orthopedic surgery: A systematic review and meta-analysis.BMC anesthesiology · 2024Pooled it
- Risk factors for postoperative delirium in geriatric patients with hip fracture: A systematic review and meta-analysis.Frontiers in aging neuroscience · 2022Pooled it
- Multi-output LSTM-based prediction of postoperative delirium: integrating baseline and perioperative data for enhanced risk stratification in older spine surgery patients.BioData mining · 2026Article
- Acute kidney injury and postoperative delirium.Journal of biomedical research · 2025Article
- Statin use is associated with reduced delirium and improved short-term outcomes in critically ill patients with chronic kidney disease.European journal of medical research · 2025Article
- Research progress on the interaction between multiple organ-brain axes and perioperative neurocognitive disorders: a narrative review.Frontiers in aging neuroscience · 2025Review
- Predicting postoperative delirium after hip arthroplasty for elderly patients using machine learning.Aging clinical and experimental research · 2023Article
- Relationship between Nonhepatic Serum Ammonia Levels and Sepsis-Associated Encephalopathy: A Retrospective Cohort Study.Emergency medicine international · 2023Article
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundThere are few studies demonstrating how kidney function affects the risk of developing delirium in older adult surgical patients administered opioids. This study determined whether baseline kidney function influences the relationship between morphine equivalent dose and the development of delirium on postoperative day (POD) 2 in patients with hip fracture.
methodsThis retrospective study analyzed emergency department (ED) estimated glomerular filtration rate (eGFR), perioperative serum creatinine, intravenous morphine equivalents, and POD2 delirium assessment by the Confusion Assessment Method in 652 patients aged 65 years or older without preoperative delirium. ED eGFR was used to divide subjects into groups by presence or absence of chronic kidney disease (CKD), and associations of opioid dose with POD2 delirium were compared using multivariable logistic regression.
resultsPOD2 delirium incidence was 29.8% (N = 194). Intraoperative and postanesthesia care unit (PACU) morphine equivalent dosage as well as ED eGFR were similar comparing patients with and without POD2 delirium. Age, American Society of Anesthesiologists status, and dementia were associated with delirium on POD2. The odds of POD2 delirium increased significantly with increase of intraoperative opioid in patients with CKD (odds ratio = 1.6; 95% confidence interval = 1.2-2.2), but not in patients without CKD (P-interaction = .04). PACU or POD1 opioid doses were not associated with POD2 delirium after covariate adjustment.
conclusionThis study suggests that incremental increases in intraoperative opioids combined with CKD increase odds of POD2 delirium after hip fracture repair, compared with patients without CKD.
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