Comparative effects of fentanyl, morphine, and hydromorphone on postoperative delirium and outcomes after cardiac surgery: a propensity score-matched cohort study.

ABSTRACT: Postoperative delirium (POD) significantly increases mortality and medical burden, however, evidence regarding the best opioid options after cardiac surgery remains limited.Using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, we identified 8246 adult patients receiving > 70% of postoperative 24-h morphine milligram equivalents (MMEs) during the ICU length of stay as fentanyl, morphine, or hydromorphone. After 1:1:1 propensity score matching (PSM) (n = 701 per group), we compared POD incidence, mortality, length of stay, vasopressor- and ventilator-free days within 28 days.The matched cohort of 2103 patients showed balanced baseline characteristics (all SMD < 0.1). POD incidence was significantly lower in the morphine (10.6%) and hydromorphone (9.7%) groups than in

SUBMITTER: Xiao L 

PROVIDER: S-EPMC12749987 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature