Association between delirium and medications used for stress ulcer prophylaxis

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Created On: 07/10/2021

Association between delirium and medications used for stress ulcer prophylaxis

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).

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Key take away

Compared to proton-pump inhibitors, histamine-2 receptor antagonists are more significantly linked with elevated delirium.

Background

Method

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.

Result

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).

Conclusion

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.