TABLE 3.
Pain Severity as a Risk Factor for the Transition to Delirium After Multiple Imputation by Chained Equations Use
| Mental Status | Pain | Controlling for Opioid Exposure and Dose | Adjusted ORa,b (95% CI), n = 14,013 | |
|---|---|---|---|---|
| Day t | Day t + 1 | |||
| Awake without delirium | Awake without delirium | No | Reference | Reference |
| Awake without delirium | Delirium | Mild/moderate/severe pain (vs. no pain) | No | 1.00 (0.80–1.26) |
| Yes | 0.96 (0.76–1.21) | |||
| 10 mg MEQ | 1.00 (0.80–1.26) | |||
| Awake without delirium | Delirium | Moderate/severe pain (vs. no/mild pain) | No | 0.95 (0.75–1.21) |
| Yes | 0.91 (0.71–1.15) | |||
| 10 mg MEQ | 0.95 (0.75–1.21) | |||
| Awake without delirium | Delirium | Severe pain (vs. no/mild/moderate pain) | No | 1.00 (0.69–1.44) |
| Yes | 0.95 (0.66–1.38) | |||
| 10 mg MEQ | 0.99 (0.69–1.44) | |||
| Awake without delirium | Delirium | Severe pain (vs. no pain) | No | 1.02 (0.69–1.52) |
| Yes | 0.94 (0.63–1.41) | |||
| 10 mg MEQ | 1.02 (0.68–1.52) | |||
| Awake without delirium | Delirium | Moderate pain (vs. no pain) | No | 0.95 (0.70–1.30) |
| Yes | 0.90 (0.66–1.24) | |||
| 10 mg MEQ | 0.94 (0.69–1.30) | |||
| Awake without delirium | Delirium | Mild pain (vs. no pain) | No | 1.02 (0.80–1.32) |
| Yes | 1.00 (0.77–1.28) | |||
| 10 mg MEQ | 1.02 (0.80–1.32) | |||
MEQ = morphine equivalent, OR = odds ratio.
a
Adjusted for time-fixed covariables, including admission category (medical, surgical, and trauma), age, sex, Acute Physiology and Chronic Health Evaluation IV score, body mass index, and Charlson Comorbidity Index.
b
Adjusted for time-varying covariables on day t, including day of ICU admission, modified Sequential Organ Failure Assessment score (without neurologic component), use of invasive mechanical ventilation, use of a benzodiazepine, and use of an opioid.