Evidence map›Paper›PMID 34959040›Full record

ArticleJournal of psychosomatic research2022

Opioid and benzodiazepine use in the emergency department and the recognition of delirium within the first 24 hours of hospitalization.

Sangil Lee, Uche Eseoghene Okoro, Morgan Bobb Swanson, Nicholas Mohr, Brett Faine, Ryan Carnahan

Open access · greenAbstract read
In one paragraph

Article in Journal of psychosomatic research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 22% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Review
  6. Article
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

6 authors at 1 institution in 1 country.

Sangil LeeDepartment of Emergency Medicine, The University of Iowa Carver College of Medicine, USA. Electronic address: Sangil-lee@uiowa.edu.
Uche Eseoghene OkoroDepartment of Emergency Medicine, The University of Iowa Carver College of Medicine, USA.
Morgan Bobb SwansonDepartment of Emergency Medicine, The University of Iowa Carver College of Medicine, USA.
Nicholas MohrDepartment of Emergency Medicine, Anesthesia, and Epidemiology, The University of Iowa Carver College of Medicine, USA.
Brett FaineDepartment of Emergency Medicine, The University of Iowa Carver College of Medicine, USA.
Ryan CarnahanDepartment of Epidemiology, University of Iowa College of Public Health, USA.
University of Iowa · US

Funding

The University of Iowa Clinical and Translational Science AwardUL1TR002537 · NCATS · UNIVERSITY OF IOWA · PI HANSEN, MARLAN R, WINOKUR, PATRICIA · 2018 to 2022
$20.0M
Medical Scientist Training ProgramT32GM139776 · NIGMS · UNIVERSITY OF IOWA · PI Gordon F Buchanan · 2021 to 2026
$6.4M
NCATS NIH HHS UL1 TR002537NIGMS NIH HHS T32 GM139776
6 · The paper itself

Abstract

objectiveDelirium is a common and serious brain dysfunction. The objective of our study was to test the hypothesis that opioids and benzodiazepines exposure in the emergency department (ED) is associated with delirium.

methodsThis was a retrospective cohort study, including patients aged 65 years and older who were hospitalized from ED at an academic medical center from 2014 to 2017. Medication administration records were used to identify opioids and benzodiazepines given during the ED stay. Nurses used the Delirium Observation Screening Scale (DOSS) twice daily to assess delirium during hospitalization. The outcome was a positive DOSS within 1 day of ED encounter. We used logistic regression to predict the outcome of positive delirium screening by opioids and benzodiazepines.

resultsA total of 7927 ED encounters that resulted in hospitalization were included in the analysis. We identified 2008 visits (25.3%) with a positive delirium screen. A total of 3304 (41.7%) received opioids, and 1801 (22.7%) received benzodiazepines. In this cohort, opioids were not associated with an increased odds of delirium (OR 1.00, 95% CI 0.87-1.15). Benzodiazepines were associated with increased odds of delirium (OR 1.37, 95% CI 1.13-1.65), as were benzodiazepines combined with opioids (OR 1.61, 95% CI 1.33-1.97).

conclusionIn this study, the use of benzodiazepines was associated with a risk of delirium. The use of opioids did not increase the risk of delirium. Our findings imply that judicious pain management with opioids in the ED might not increase the risk of delirium.

Indexed as

Analgesics, OpioidDeliriumBenzodiazepinesEmergency Service, HospitalHospitalizationHumansRetrospective StudiesAnalgesics, OpioidBenzodiazepinesDeliriumEmergency departmentHigh-risk medicationsPrediction

Identifiers

PMID34959040
PMCPMC9348903
OpenAlexW4200082360

What OpenQuestion holds

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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.