Opioid medications and longitudinal risk of delirium in hospitalized cancer patients
BACKGROUND. Delirium is an important problem in hospitalized cancer patients. The objective of this study was to determine whether exposure to corticosteroids, benzodiazepines, or opioids predicted delirium. METHODS. A prospective cohort study was conducted in an oncology/internal medicine populatio...
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| Veröffentlicht in: | Cancer 2007-06, Vol.109 (11), p.2365-2373 |
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| container_title | Cancer |
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| creator | Gaudreau, Jean‐David Gagnon, Pierre Roy, Marc‐André Harel, François Tremblay, Annie |
| description | BACKGROUND.
Delirium is an important problem in hospitalized cancer patients. The objective of this study was to determine whether exposure to corticosteroids, benzodiazepines, or opioids predicted delirium.
METHODS.
A prospective cohort study was conducted in an oncology/internal medicine population. Patients were assessed continuously for the presence of delirium until they were discharged by using the Nursing Delirium Screening Scale (Nu‐DESC). Follow‐up for outcome began after incident delirium. The primary outcome was the presence of a delirium event, which was defined as a Nu‐DESC score >1. Strengths of associations of medications with delirium were expressed as odds ratios (ORs) in univariate and multivariate analyses.
RESULTS.
In total, 114 patients (1823 patient‐days) met the inclusion criteria for the study. The mean follow‐up from incident delirium was 16 days. The mean number of delirium events by patient was 6 (total number, 667 delirium events). Analysis by day on several occasions revealed significant associations between opioids and delirium. Corticosteroids and benzodiazepines were not associated significantly with an increased risk of delirium on any given day. Analysis by patient using generalized estimating equation (GEE) models showed an increased risk of delirium on any day of follow‐up associated with opioid exposure in univariate analysis (OR of 1.70; P < .0001). The association remained significant after adjustment for corticosteroid, benzodiazepine, and antipsychotic exposure using GEE regressions (OR of 1.37; P = .0033). Truncating follow‐up at 30 days did not affect the results (OR of 1.38; P < .032).
CONCLUSIONS.
Exposure to opioids during hospitalization was associated significantly with an increased longitudinal risk of delirium. Cancer 2007. © 2007 American Cancer Society.
Delirium is a highly prevalent psychiatric condition in oncology. Exposure to opioids during hospitalization is associated significantly with an increased longitudinal risk of delirium in hospitalized cancer patients. |
| doi_str_mv | 10.1002/cncr.22665 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1002_cncr_22665</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>CNCR22665</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4845-2bca06bd42273774bd06390c8b6a8c455458aacb1ff777447a2773b570344f283</originalsourceid><addsrcrecordid>eNp9kEtLAzEUhYMotlY3_gDJxo0wNe9MlzLUBxQLUsHdkEkyGp1mhmSK1F9v6hS6c3W53I9z7jkAXGI0xQiRW-11mBIiBD8CY4xmMkOYkWMwRgjlGWf0bQTOYvxMqyScnoIRlkzMsGBjsFp2rnUGrq1xWvWu9REqb2DT-nfXb4zzqoHBxS_Y1tDYxgW3WUPn4UcbO9erxv1YA7Xy2gbYJQHr-3gOTmrVRHuxnxPwej9fFY_ZYvnwVNwtMs1yxjNSaYVEZRghkkrJKoMEnSGdV0LlmnHOeK6UrnBdy3RmUhEpacUloozVJKcTcDPo6tDGGGxddsGtVdiWGJW7aspdNeVfNQm-GuBuU6W0B3TfRQKu94CKWjV1SKFcPHC5FDT9lzg8cN-usdt_LMviuXgZzH8Bgel75Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Opioid medications and longitudinal risk of delirium in hospitalized cancer patients</title><source>MEDLINE</source><source>Wiley Online Library Free Content</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Gaudreau, Jean‐David ; Gagnon, Pierre ; Roy, Marc‐André ; Harel, François ; Tremblay, Annie</creator><creatorcontrib>Gaudreau, Jean‐David ; Gagnon, Pierre ; Roy, Marc‐André ; Harel, François ; Tremblay, Annie</creatorcontrib><description>BACKGROUND.
Delirium is an important problem in hospitalized cancer patients. The objective of this study was to determine whether exposure to corticosteroids, benzodiazepines, or opioids predicted delirium.
METHODS.
A prospective cohort study was conducted in an oncology/internal medicine population. Patients were assessed continuously for the presence of delirium until they were discharged by using the Nursing Delirium Screening Scale (Nu‐DESC). Follow‐up for outcome began after incident delirium. The primary outcome was the presence of a delirium event, which was defined as a Nu‐DESC score >1. Strengths of associations of medications with delirium were expressed as odds ratios (ORs) in univariate and multivariate analyses.
RESULTS.
In total, 114 patients (1823 patient‐days) met the inclusion criteria for the study. The mean follow‐up from incident delirium was 16 days. The mean number of delirium events by patient was 6 (total number, 667 delirium events). Analysis by day on several occasions revealed significant associations between opioids and delirium. Corticosteroids and benzodiazepines were not associated significantly with an increased risk of delirium on any given day. Analysis by patient using generalized estimating equation (GEE) models showed an increased risk of delirium on any day of follow‐up associated with opioid exposure in univariate analysis (OR of 1.70; P < .0001). The association remained significant after adjustment for corticosteroid, benzodiazepine, and antipsychotic exposure using GEE regressions (OR of 1.37; P = .0033). Truncating follow‐up at 30 days did not affect the results (OR of 1.38; P < .032).
CONCLUSIONS.
Exposure to opioids during hospitalization was associated significantly with an increased longitudinal risk of delirium. Cancer 2007. © 2007 American Cancer Society.
Delirium is a highly prevalent psychiatric condition in oncology. Exposure to opioids during hospitalization is associated significantly with an increased longitudinal risk of delirium in hospitalized cancer patients.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.22665</identifier><identifier>PMID: 17469164</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adrenal Cortex Hormones - adverse effects ; Analgesics, Opioid - adverse effects ; Benzodiazepines - adverse effects ; Biological and medical sciences ; Cohort Studies ; delirium ; Delirium - chemically induced ; Female ; Geriatrics ; hemato‐oncology ; Hospitalization ; Humans ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Neoplasms - complications ; Neoplasms - diagnosis ; Neoplasms - drug therapy ; opioids ; Prospective Studies ; psychoactive medications ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychotropic Drugs - adverse effects ; Risk Assessment ; Tumors</subject><ispartof>Cancer, 2007-06, Vol.109 (11), p.2365-2373</ispartof><rights>Copyright © 2007 American Cancer Society</rights><rights>2007 INIST-CNRS</rights><rights>(c) 2007 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4845-2bca06bd42273774bd06390c8b6a8c455458aacb1ff777447a2773b570344f283</citedby><cites>FETCH-LOGICAL-c4845-2bca06bd42273774bd06390c8b6a8c455458aacb1ff777447a2773b570344f283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.22665$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.22665$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18763639$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17469164$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gaudreau, Jean‐David</creatorcontrib><creatorcontrib>Gagnon, Pierre</creatorcontrib><creatorcontrib>Roy, Marc‐André</creatorcontrib><creatorcontrib>Harel, François</creatorcontrib><creatorcontrib>Tremblay, Annie</creatorcontrib><title>Opioid medications and longitudinal risk of delirium in hospitalized cancer patients</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND.
Delirium is an important problem in hospitalized cancer patients. The objective of this study was to determine whether exposure to corticosteroids, benzodiazepines, or opioids predicted delirium.
METHODS.
A prospective cohort study was conducted in an oncology/internal medicine population. Patients were assessed continuously for the presence of delirium until they were discharged by using the Nursing Delirium Screening Scale (Nu‐DESC). Follow‐up for outcome began after incident delirium. The primary outcome was the presence of a delirium event, which was defined as a Nu‐DESC score >1. Strengths of associations of medications with delirium were expressed as odds ratios (ORs) in univariate and multivariate analyses.
RESULTS.
In total, 114 patients (1823 patient‐days) met the inclusion criteria for the study. The mean follow‐up from incident delirium was 16 days. The mean number of delirium events by patient was 6 (total number, 667 delirium events). Analysis by day on several occasions revealed significant associations between opioids and delirium. Corticosteroids and benzodiazepines were not associated significantly with an increased risk of delirium on any given day. Analysis by patient using generalized estimating equation (GEE) models showed an increased risk of delirium on any day of follow‐up associated with opioid exposure in univariate analysis (OR of 1.70; P < .0001). The association remained significant after adjustment for corticosteroid, benzodiazepine, and antipsychotic exposure using GEE regressions (OR of 1.37; P = .0033). Truncating follow‐up at 30 days did not affect the results (OR of 1.38; P < .032).
CONCLUSIONS.
Exposure to opioids during hospitalization was associated significantly with an increased longitudinal risk of delirium. Cancer 2007. © 2007 American Cancer Society.
Delirium is a highly prevalent psychiatric condition in oncology. Exposure to opioids during hospitalization is associated significantly with an increased longitudinal risk of delirium in hospitalized cancer patients.</description><subject>Adrenal Cortex Hormones - adverse effects</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Benzodiazepines - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>delirium</subject><subject>Delirium - chemically induced</subject><subject>Female</subject><subject>Geriatrics</subject><subject>hemato‐oncology</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - diagnosis</subject><subject>Neoplasms - drug therapy</subject><subject>opioids</subject><subject>Prospective Studies</subject><subject>psychoactive medications</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychotropic Drugs - adverse effects</subject><subject>Risk Assessment</subject><subject>Tumors</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEUhYMotlY3_gDJxo0wNe9MlzLUBxQLUsHdkEkyGp1mhmSK1F9v6hS6c3W53I9z7jkAXGI0xQiRW-11mBIiBD8CY4xmMkOYkWMwRgjlGWf0bQTOYvxMqyScnoIRlkzMsGBjsFp2rnUGrq1xWvWu9REqb2DT-nfXb4zzqoHBxS_Y1tDYxgW3WUPn4UcbO9erxv1YA7Xy2gbYJQHr-3gOTmrVRHuxnxPwej9fFY_ZYvnwVNwtMs1yxjNSaYVEZRghkkrJKoMEnSGdV0LlmnHOeK6UrnBdy3RmUhEpacUloozVJKcTcDPo6tDGGGxddsGtVdiWGJW7aspdNeVfNQm-GuBuU6W0B3TfRQKu94CKWjV1SKFcPHC5FDT9lzg8cN-usdt_LMviuXgZzH8Bgel75Q</recordid><startdate>20070601</startdate><enddate>20070601</enddate><creator>Gaudreau, Jean‐David</creator><creator>Gagnon, Pierre</creator><creator>Roy, Marc‐André</creator><creator>Harel, François</creator><creator>Tremblay, Annie</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20070601</creationdate><title>Opioid medications and longitudinal risk of delirium in hospitalized cancer patients</title><author>Gaudreau, Jean‐David ; Gagnon, Pierre ; Roy, Marc‐André ; Harel, François ; Tremblay, Annie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4845-2bca06bd42273774bd06390c8b6a8c455458aacb1ff777447a2773b570344f283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adrenal Cortex Hormones - adverse effects</topic><topic>Analgesics, Opioid - adverse effects</topic><topic>Benzodiazepines - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>delirium</topic><topic>Delirium - chemically induced</topic><topic>Female</topic><topic>Geriatrics</topic><topic>hemato‐oncology</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - diagnosis</topic><topic>Neoplasms - drug therapy</topic><topic>opioids</topic><topic>Prospective Studies</topic><topic>psychoactive medications</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychotropic Drugs - adverse effects</topic><topic>Risk Assessment</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gaudreau, Jean‐David</creatorcontrib><creatorcontrib>Gagnon, Pierre</creatorcontrib><creatorcontrib>Roy, Marc‐André</creatorcontrib><creatorcontrib>Harel, François</creatorcontrib><creatorcontrib>Tremblay, Annie</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gaudreau, Jean‐David</au><au>Gagnon, Pierre</au><au>Roy, Marc‐André</au><au>Harel, François</au><au>Tremblay, Annie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Opioid medications and longitudinal risk of delirium in hospitalized cancer patients</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2007-06-01</date><risdate>2007</risdate><volume>109</volume><issue>11</issue><spage>2365</spage><epage>2373</epage><pages>2365-2373</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND.
Delirium is an important problem in hospitalized cancer patients. The objective of this study was to determine whether exposure to corticosteroids, benzodiazepines, or opioids predicted delirium.
METHODS.
A prospective cohort study was conducted in an oncology/internal medicine population. Patients were assessed continuously for the presence of delirium until they were discharged by using the Nursing Delirium Screening Scale (Nu‐DESC). Follow‐up for outcome began after incident delirium. The primary outcome was the presence of a delirium event, which was defined as a Nu‐DESC score >1. Strengths of associations of medications with delirium were expressed as odds ratios (ORs) in univariate and multivariate analyses.
RESULTS.
In total, 114 patients (1823 patient‐days) met the inclusion criteria for the study. The mean follow‐up from incident delirium was 16 days. The mean number of delirium events by patient was 6 (total number, 667 delirium events). Analysis by day on several occasions revealed significant associations between opioids and delirium. Corticosteroids and benzodiazepines were not associated significantly with an increased risk of delirium on any given day. Analysis by patient using generalized estimating equation (GEE) models showed an increased risk of delirium on any day of follow‐up associated with opioid exposure in univariate analysis (OR of 1.70; P < .0001). The association remained significant after adjustment for corticosteroid, benzodiazepine, and antipsychotic exposure using GEE regressions (OR of 1.37; P = .0033). Truncating follow‐up at 30 days did not affect the results (OR of 1.38; P < .032).
CONCLUSIONS.
Exposure to opioids during hospitalization was associated significantly with an increased longitudinal risk of delirium. Cancer 2007. © 2007 American Cancer Society.
Delirium is a highly prevalent psychiatric condition in oncology. Exposure to opioids during hospitalization is associated significantly with an increased longitudinal risk of delirium in hospitalized cancer patients.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>17469164</pmid><doi>10.1002/cncr.22665</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Cancer, 2007-06, Vol.109 (11), p.2365-2373 |
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| source | MEDLINE; Wiley Online Library Free Content; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adrenal Cortex Hormones - adverse effects Analgesics, Opioid - adverse effects Benzodiazepines - adverse effects Biological and medical sciences Cohort Studies delirium Delirium - chemically induced Female Geriatrics hemato‐oncology Hospitalization Humans Longitudinal Studies Male Medical sciences Middle Aged Neoplasms - complications Neoplasms - diagnosis Neoplasms - drug therapy opioids Prospective Studies psychoactive medications Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychotropic Drugs - adverse effects Risk Assessment Tumors |
| title | Opioid medications and longitudinal risk of delirium in hospitalized cancer patients |
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