ArticleScientific reports2024
Opioid use and subsequent delirium risk in patients with advanced cancer in palliative care: a multicenter registry study.
Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Prevalence of delirium among patients with advanced cancer: a systematic review and meta-analysis.Frontiers in neurologyPooled it
- Is routine screening for substance use disorders useful in palliative care? Results of a prospective observational study.Substance abuse treatment, prevention, and policy · 2026Observational
- Comparative risk of delirium among opioid users for non-cancer pain: a retrospective cohort study.BMC medicine · 2026Article
- Impact of CNS medication burden and drug interactions on delirium in patients with advanced cancer: a multicenter prospective observational study.Scientific reports · 2025Observational
- Intraoperative dexmedetomidine for prevention of postoperative delirium in pediatric patients after orthopedic surgery: a single-center retrospective study.BMC pediatrics · 2025Article
- Reflecting on Cancer Pain as Constant Acute Pain, not Chronic Pain. 'Known Knowns, Known Unknowns, Unknown Unknowns'.Current oncology reports · 2025Review
- Dexmedetomidine for postoperative delirium in surgical patients: a mini-review of mechanisms, clinical evidence, and practical implementation.Frontiers in pharmacology · 2025Review
- Machine learning-based model to predict delirium in patients with advanced cancer treated with palliative care: a multicenter, patient-based registry cohort.Scientific reports · 2024Article
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Authors and funding
9 authors at 8 institutions in 2 countries.
Funding
Abstract
The prevalent use of opioids for pain management in patients with advanced cancer underscores the need for research on their neuropsychiatric impacts, particularly delirium. Therefore, we aimed to investigate the potential association between opioid use and the risk of delirium in patients with advanced cancer admitted to the acute palliative care unit. We conducted a retrospective observational study utilizing a multicenter, patient-based registry cohort by collecting the data from January 1, 2019, to December 31, 2020, in South Korea. All data regarding exposures, outcomes, and covariates were obtained through retrospective chart reviews by a team of specialized medical professionals with expertise in oncology. Full unmatched and 1:1 propensity-score matched cohorts were formed, and stratification analysis was conducted. The primary outcome, delirium, was defined and diagnosed by the DSM-IV. Of the 2,066 patients with advanced cancer, we identified 42.8% (mean [SD] age, 64.4 [13.3] years; 60.8% male) non-opioid users and 57.2% (62.8 [12.5] years; 55.9% male) opioid users, respectively. Opioid use was significantly associated with an increased occurrence of delirium in patients with advanced cancer (OR, 2.02 [95% CI 1.22-3.35]). The risk of delirium in patients with advanced cancer showed increasing trends in a dose-dependent manner. High-dose opioid users showed an increased risk of delirium in patients with advanced cancer compared to non-opioid users (low-dose user: OR, 2.21 [95% CI 1.27-3.84]; high-dose user: OR, 5.75 [95% CI 2.81-11.77]; ratio of OR, 2.60 [95% CI 1.05-6.44]). Patients with old age, male sex, absence of chemotherapy during hospitalization, and non-obese status were more susceptible to increased risk of delirium in patients with cancer. In this multicenter patient-based registry cohort study, we found a significant, dose-dependent association between opioid use and increased risk of delirium in patients with advanced cancer. We also identified specific patient groups more susceptible to delirium. These findings highlight the importance of opioid prescription in these patients with advanced cancer, balancing effective doses for pain management and adverse dose-inducing delirium.
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