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

doi:10.1016/j.jpsychores.2021.110704

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

Journal article

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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 and Ryan Carnahan

Journal of psychosomatic research, Vol.153, pp.110704-110704

02/01/2022

DOI: 10.1016/j.jpsychores.2021.110704

PMCID: PMC9348903

PMID: 34959040

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https://www.ncbi.nlm.nih.gov/pmc/articles/9348903View

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Abstract

Objective: Delirium 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. Methods: This 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. Results: A 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). Conclusion: In 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.

Life Sciences & Biomedicine

Psychiatry

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Details

Title: Subtitle: Opioid and benzodiazepine use in the emergency department and the recognition of delirium within the first 24 hours of hospitalization
Creators: Sangil Lee - Roy J. and Lucille A. Carver College of Medicine
Uche Eseoghene Okoro - Roy J. and Lucille A. Carver College of Medicine
Morgan Bobb Swanson - Roy J. and Lucille A. Carver College of Medicine
Nicholas Mohr - Roy J. and Lucille A. Carver College of Medicine
Brett Faine - Roy J. and Lucille A. Carver College of Medicine
Ryan Carnahan - University of Iowa
Resource Type: Journal article
Publication Details: Journal of psychosomatic research, Vol.153, pp.110704-110704
DOI: 10.1016/j.jpsychores.2021.110704
PMID: 34959040
PMCID: PMC9348903
NLM abbreviation: J Psychosom Res
ISSN: 0022-3999
eISSN: 1879-1360
Publisher: Elsevier
Number of pages: 6
Grant note: department of emergency medicine at the University of Iowa Carver College of Medicine UL1TR002537 / National Center For Advancing Translational Sciences of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
Language: English
Date published: 02/01/2022
Academic Unit: Epidemiology; Emergency Medicine; Biostatistics; Nursing; Pharmacy Practice and Science; Anesthesia; Injury Prevention Research Center
Record Identifier: 9984295925302771

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