{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:29:49Z","timestamp":1791217789864,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T00:00:00Z","timestamp":1591833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","award":["29307"],"award-info":[{"award-number":["29307"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Emergency department (ED) stay and its associated conditions (immobility, inadequate hydration and nutrition, lack of stimulation) increase the risk of delirium in older patients. Poorly controlled pain and paradoxically opioid pain treatment have also been identified as triggers for delirium. The aim of this study was to assess the relationship between pain, opioid treatment, and delirium in older ED patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter prospective cohort study was conducted in four hospitals across the province of Qu\u00e9bec (Canada). Patients aged\u00a0\u2265\u00a065\u00a0years old, waiting for hospital admission between March\u00a0and July\u00a02015, who were nondelirious upon ED arrival, who were independent or semi\u2010independent in their daily living activities, and who had an ED stay of at least 8\u00a0hours were included. Delirium assessments were conducted twice a day during the patient\u2019s entire ED stay and their first 24\u00a0hours on the hospital ward using the Confusion Assessment Method. Pain intensity was evaluated using a visual analog scale (VAS\u00a0= 0\u2013100) during the initial interview, and all opioid treatments were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 338 patients were included; 51% were female, and mean\u00a0(\u00b1SD) age was 77\u00a0(\u00b18)\u00a0years. Forty\u2010one patients (12%) experienced delirium during their hospital stay occurring within a mean (\u00b1SD) delay of 47\u00a0(\u00b119)\u00a0hours after ED admission. Among patients with pain intensity\u00a0\u2265\u00a065 from VAS (0\u2013100), 26% experienced delirium compared to 11% for patients with pain\u00a0&lt;\u00a065 (p\u00a0&lt;\u00a00.01), and no significant association was found between opioid consumption and delirium (p\u00a0=\u00a00.31). Logistic regression controlling for confounding factors showed that patients with pain intensity\u00a0\u2265\u00a065 are 3.3 (95% confidence interval\u00a0= 1.4 to 7.9) times more likely to develop delirium than patients who had pain\u00a0intensity of &lt;65.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Severe pain, not opioids, is associated with the development of delirium during ED stay. Adequate pain control during the hospital stay may contribute to a decrease in delirium episodes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.14033","type":"journal-article","created":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T06:01:37Z","timestamp":1590127297000},"page":"708-716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Relationship Between Pain, Opioid Treatment, and Delirium in Older Emergency Department Patients"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-0198","authenticated-orcid":false,"given":"Raoul","family":"Daoust","sequence":"first","affiliation":[{"name":"From the Centre d\u2019\u00c9tude en M\u00e9decine d\u2019Urgence H\u00f4pital du Sacr\u00e9\u2010C\u0153ur de Montr\u00e9al Montr\u00e9al Qu\u00e9bec Canada"},{"name":"the Facult\u00e9 de M\u00e9decine D\u00e9partement M\u00e9decine Familiale et M\u00e9decine 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