Department of Anesthesiology, Shenzhen People's Hospital, Shenzhen, China.
The Second Clinical Medical College, Jinan University, Shenzhen, China.
J Int Med Res. 2022 Apr;50(4):3000605221088695. doi: 10.1177/03000605221088695.
To observe the association between exposure to midazolam within 24 hours prior to delirium assessment and the risk of delirium.
We performed a systematic cohort study with two sets of cohorts to estimate the relative risks of outcomes among patients administered midazolam within 24 hours prior to delirium assessment. Propensity score matching was performed to generate a balanced 1:1 matched cohort and identify potential prognostic factors. The outcomes included the odds of delirium, mortality, length of intensive care unit stay, length of hospitalization, and odds of being discharged home.
A total of 78,364 patients were included in this study, of whom 22,159 (28.28%) had positive records. Propensity matching successfully balanced covariates for 9348 patients (4674 per group). Compared with no administration of midazolam, midazolam administration was associated with a significantly higher risk of delirium, higher mortality, and a longer intensive care unit stay. Patients treated with midazolam were relatively less likely to be discharged home. There was no significant difference in hospitalization duration.
Midazolam may be an independent risk factor for delirium in critically ill patients.
观察谵妄评估前 24 小时内接触咪达唑仑与谵妄风险之间的关联。
我们进行了一项系统队列研究，包括两组队列，以估计在谵妄评估前 24 小时内接受咪达唑仑治疗的患者的结局相对风险。采用倾向评分匹配生成平衡的 1:1 匹配队列，并确定潜在的预后因素。结局包括谵妄、死亡率、重症监护病房住院时间、住院时间和出院回家的可能性。
共有 78364 例患者纳入本研究，其中 22159 例（28.28%）有阳性记录。倾向匹配成功地平衡了 9348 例患者的协变量（每组 4674 例）。与未使用咪达唑仑相比，咪达唑仑的使用与谵妄风险显著增加、死亡率更高和重症监护病房住院时间延长相关。接受咪达唑仑治疗的患者出院回家的可能性相对较低。住院时间无显著差异。
咪达唑仑可能是危重症患者谵妄的一个独立危险因素。
