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ICU Cohort Assessed Baseline Anxiety and Depression While Adjusting for Daily Benzodiazepine Exposure
A prospective cohort found combined baseline anxiety and depression associated with delirium. Benzodiazepine use was a modeled covariate, not the main intervention under study.
A prospective cohort found combined baseline anxiety and depression associated with delirium. Benzodiazepine use was a modeled covariate, not the main intervention under study.
The clinical observation
The analysis included 991 patients. Delirium occurred more often in the group reporting both baseline anxiety and depression than in those reporting neither. The adjusted association also persisted for occurrence and duration.
Models included illness measures, cognition, coma, ICU time, and daily opioid or benzodiazepine use.
Adjustment does not randomize treatment
Including a medicine in a model does not prove its independent causal effect or guarantee removal of every prescribing-related difference. Mental-health symptoms, illness severity, and sedation decisions can interact over time.
The delirium definition included assessment findings and scheduled antipsychotic use, which also deserves attention when interpreting the endpoint. This paper supports considering baseline psychological state in risk assessment. It cannot establish that benzodiazepines explain the association or that treating anxiety differently would necessarily have prevented an individual episode.
Source paper
Original analysis of the supplied journal article, identified as PMC9307302.