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Meperidine analgesia and delirium in aged hip fracture patients.
MedLine Citation:
PMID:  14764364     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Delirium is quite frequent in elderly patients who sustain hip fractures. The use of Meperidine by physicians, unaware of the possible emergence of delirium in elderly patients, is very popular. We have retrospectively examined the incidence of delirium in 181 consecutive patients admitted to the orthogeriatric ward with hip fractures. We used the confusion assessment method to establish the presence of delirium in all patients. A database search was conducted to identify which patients were treated by Meperidine, or Morphine, prior to delirium onset. We identified 92 cases, 44 of whom were treated by Meperidine alone, and the other 48 treated by Morphine alone. Delirium was diagnosed in 13 (27.1%) Morphine treated patients as compared with 19 (43.2%) treated by Meperidine (P<0.001). Age, cognitive status and opiate use were associated with perioperative delirium. A subset regression analysis showed that exposure to Meperidine was significantly associated with delirium (odds ratio 2.5, P<0.01), in contrast with Morphine. Our results confirm the association between exposure to Meperidine and delirium, suggesting that this drug should be withdrawn in elderly hip fractured patients undergoing surgery, and substituted by low dose Morphine analgesia. Reducing the incidence of delirium, by adopting such an approach, may result in a significant potential of savings in direct costs, related to treatment of delirium in this population.
Authors:
Abraham Adunsky; Rami Levy; Michael Heim; Eliyahu Mizrahi; M Arad
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of gerontology and geriatrics     Volume:  35     ISSN:  0167-4943     ISO Abbreviation:  Arch Gerontol Geriatr     Publication Date:    2002 Nov-Dec
Date Detail:
Created Date:  2004-02-06     Completed Date:  2004-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214379     Medline TA:  Arch Gerontol Geriatr     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  253-9     Citation Subset:  -    
Affiliation:
Department of Orthopedic-Geriatric Medicine, Bitan 38, Sheba Medical Center, Tel Hashomer 52621, Israel. eadunsky@hotmail.com
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