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Relationship Between Pain and Opioid Analgesics on the Development of Delirium Following Hip Fracture

The Journals of Gerontology Series A · 2003 · Vol. 58(1) · pp. M76–M81
R. Sean MorrisonJay MagazinerM S GilbertKenneth J. KovalMarκ McLaughlinGretchen M. OroszEric J. StraussAlbert L. Siu

Abstract

Using admission data, clinicians can identify patients at high risk for delirium following hip fracture. Avoiding opioids or using very low doses of opioids increased the risk of delirium. Cognitively intact patients with undertreated pain were nine times more likely to develop delirium than patients whose pain was adequately treated. Undertreated pain and inadequate analgesia appear to be risk factors for delirium in frail older adults.

Intensive Care Unit Cognitive DisordersAnesthesia and Sedative AgentsAnesthesia and Neurotoxicity ResearchDeliriumMedicineHip fractureProspective cohort studyRelative riskAnesthesiaCohort studyConfidence intervalInternal medicineIntensive care medicine

MeSH terms

AgedAged, 80 and overAnalgesics, OpioidDeliriumDose-Response Relationship, DrugFemaleFollow-Up StudiesHip FracturesHumansMaleMiddle AgedNew York CityPainPain MeasurementPostoperative Period

Funding

  • Open Society Institute
  • Agency for Healthcare Research and Quality
  • National Institute on Aging
Citations
786
FWCI
14.66
field-weighted impact
References
25
Percentile
99%
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Journal of the American Geriatrics Society · 2000 · 684 citations
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Annals of Internal Medicine · 1990 · 5,218 citations
A validation of the Functional Independence Measurement and its performance among rehabilitation inpatients
Archives of Physical Medicine and Rehabilitation · 1993 · 1,037 citations
Reducing Delirium After Hip Fracture: A Randomized Trial
Journal of the American Geriatrics Society · 2001 · 1,370 citations
Agency for Health Care Policy and Research
Medical Care · 1999 · 1,374 citations
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Relationship Between Pain and Opioid Analgesics on the Development of Delirium Following Hip Fracture · Scinovex