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With the aid of deidentified database source, this retrospective observational cohort study assessed differential associations of histamine-2 (H2) receptor antagonist or proton-pump inhibitor (PPI) administration (medicines used for stress ulcer prophylaxis) with delirium development in adults admitted to an intensive care unit (ICU).
Compared to proton-pump inhibitors,
histamine-2 receptor antagonists are more significantly linked with elevated
delirium.
With the aid of deidentified database source, this
retrospective observational cohort study assessed differential associations of
histamine-2 (H2) receptor antagonist or proton-pump inhibitor (PPI)
administration (medicines used for stress ulcer prophylaxis) with delirium development
in adults admitted to an intensive care unit (ICU).
Identification of the recruited people with
delirium was done with the aid of an International Classification of
Diseases-based algorithm. Relation among H2 receptor antagonist, PPI, or no
medication administration and delirium were recognized using relative risk.
Multiple logistic regression was utilized for controlling the potential
confounders, including age and mechanical ventilation.
Overall, 6645 critically ill people were recognized, of whom 29% (n= 1,899) were given mechanical ventilation, 45% (n= 3,022) were 65 years or older, and 22% (n= 1,487) died during their hospitalization. Out of 6645 people, 31% (n= 2,057) were administered an H2 receptor antagonist and no PPI, 40% (n= 2,648) were administered a PPI and no H2 receptor antagonists, and 46% (n = 3,076) were reported to have delirium.
The H2 receptor antagonist group exhibited a higher link
with delirium than the PPI group compared with controls receiving neither medicine
after controlling for mechanical ventilation (risk ratio 1.36 and age (risk
ratio 1.15).
H2 blockers were more strongly linked with an increased risk
of delirium when compared to PPIs. Prospective studies are warranted for
further elucidating this link and determining if the replacement of H2 blockers
with PPI in ICUs reduces the delirium burden in high-risk people.
Critical Care Explorations
Association of Histamine-2 Blockers and Proton-Pump Inhibitors With Delirium Development in Critically Ill Adults: A Retrospective Cohort Study
Ami Shiddapur et al.
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