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- Title
Evaluating Pain, Opioids, and Delirium in Critically Ill Older Adults.
- Authors
Pavone, Kara J.; Jablonski, Juliane; Cacchione, Pamela Z.; Polomano, Rosemary C.; Compton, Peggy
- Abstract
Untreated pain and pain management with opioids are independent precipitating factors for delirium. This retrospective study evaluated the relationships among pain severity, its management with opioids, and the onset of delirium in older adult patients admitted to the surgical intensive care unit (SICU). Consecutive patients aged 65 or greater admitted to the SICU over a 5-month period were examined (n = 172). When assessed using a multivariable general estimating equation model, opioids (chi-square [χ2], 12.34, p =.0004), but not pain (χ2, 3.31, p =.0688) were significant in predicting next-day delirium status. Controlling for pain, patients exposed to opioids were 2.5 times more likely to develop delirium than patients not exposed (95% Confidence Interval: 1.44–4.36). Our data shows that opioid administration predicted the onset of next-day delirium. In an effort to prevent delirium, future research should focus on opioid-sparing pain management approaches to mitigate pain and delirium.
- Subjects
THERAPEUTIC use of narcotics; DIAGNOSIS of delirium; INTENSIVE care units; PAIN; SCIENTIFIC observation; CONFIDENCE intervals; CRITICALLY ill; PATIENTS; RETROSPECTIVE studies; SEVERITY of illness index; T-test (Statistics); DESCRIPTIVE statistics; CHI-squared test; CRITICAL care medicine; DATA analysis software; PAIN management
- Publication
Clinical Nursing Research, 2021, Vol 30, Issue 4, p455
- ISSN
1054-7738
- Publication type
Article
- DOI
10.1177/1054773820973123