ArticleClinics (Sao Paulo, Brazil)2025
The impact of early morphine administration on septic patients with pre-existing chronic heart failure.
Article in Clinics (Sao Paulo, Brazil), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe use, timing, and dosage of morphine in septic patients with a history of Chronic Heart Failure (CHF) are poorly studied, and it is still unclear if morphine administration affects sepsis survival. This study aims to elucidate the relationship between early morphine administration and 30-day mortality among septic patients with a history of CHF.
methodsUtilizing data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, this retrospective cohort study focuses on septic patients with CHF. The authors investigated the effects of early morphine administration (within 24 h of ICU admission) on 30-day mortality, employing Cox proportional hazards modeling and Propensity Score Matching (PSM) for analysis.
resultsThe authors analyzed 7424 adult septic patients with CHF, among whom 6495 received early morphine and 929 were managed without morphine. The early morphine group exhibited a significantly lower 30-day mortality rate compared to the nonmorphine group (post-matched 16.4 % vs. 25.7 %, Absolute Risk Reduction (ARR) 9.3 % (95 % Confidence Interval [95 % CI 5.1-13.6], p < 0.001). Among septic patients with CHF, early morphine administration was associated with a reduction in 30-day death in all adjusted variables (HR = 0.539‒0.735, p < 0.001). After PSM, only <15 mg of morphine was correlated to a lower 30-day mortality rate (HR = 0.233, 95 % CI 0.086-0.632, p < 0.001).
conclusionThis investigation reveals a significant association between the early administration of morphine and reduced risk-adjusted 30-day mortality in septic patients with CHF.
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