ArticleCureus2024
Exploring the Association Between Intravenous Lorazepam and Mortality Among Older Hospitalized Patients With and Without Cognitive Impairment.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guideline for Medication Management of Distressing Symptoms in Older Patients Receiving End-of-Life Palliative Care.Journal of evidence-based medicine · 2026Guideline
- Assessment of postoperative outcomes of prescription benzodiazepine use in lung transplant recipients.Journal of thoracic disease · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background In a previously published study about the effects of an inpatient geriatrics program on mortality among older patients with and without cognitive impairment, intravenous (IV) lorazepam was unexpectedly found to be one of the variables associated with mortality in the multivariate analysis. The purpose of this study was to further explore the association between IV lorazepam and mortality. Materials and Methods This was a secondary data analysis of a previously published retrospective study. The setting was a 500-bed community-based hospital, Level-1 Trauma Center, and Stroke Center (Dallas, Texas, United States). Participants were all patients aged 70+ admitted between January 1, 2017, and December 31, 2019. Logistic regression was used to evaluate the association between IV lorazepam (defined as receiving ≥1 dose) and mortality (death during hospitalization) among patients with cognitive impairment [defined as in the original study using a list of >30 IInternational Classification of Diseases, Tenth Edition (ICD-10)] and without cognitive impairment. Covariables included age, gender, case mix index, ICU stay, sepsis, palliative care, oral benzodiazepines, oral and IV antipsychotics, and oral and IV opioids. Logistic regression was used to calculate the adjusted odds ratio (aORs) and 95% confidence intervals (CI) of mortality. Results Of 20,541 patients, 6,197 (30.2%) had cognitive impairment of which 1430 (23.1%) received IV lorazepam, with a mortality rate of 16.9%. Of 14,344 patients without cognitive impairment, 1,468 (10.2%) received IV lorazepam, with a mortality rate of 32.0%. After controlling for covariables, aORs for mortality among those who received IV lorazepam was 3.37 (95% CI: 2.52-4.50) for patients with cognitive impairment and 7.72 (95% confidence interval (CI): 6.09-9.79) without cognitive impairment. Even when ICU and palliative care patients were excluded, aOR for mortality remained high for those with (4.09; 95% CI: 2.17-7.69) and without cognitive impairment, 18.82 (95% CI: 13.39-26.46). Conclusion Despite the limitations of this exploratory study, including a lack of data on the dosage and duration of IV lorazepam, further research is warranted to examine the possible association between IV lorazepam and increased mortality among older hospitalized patients, both with and without cognitive impairment.
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