Is Dexmedetomidine or Olanzapine Suitable to Control Delirium in Elder Critical Ill Patients?: A Retrospective Cohort Study

Background: The efficacy and safety of dexmedetomidine and olanzapine for delirium control in elderly critically ill patients without ventilation or surgery are unknown. Method: In this retrospective cohort of elderly critically ill patients, the efficacy and safety of dexmedetomidine or olanzapine for controlling delirium were evaluated by drug dosage/duration, sedation level, adverse effects, intubation during sedation and prognosis. Result: From 439 screened patients, average RASS scores, drug use duration and sedative combination rates were lower, adverse effect and intubation rates were higher, and hospital stay length was longer with dexmedetomidine than olanzapine. Mortality rates, long-term cognitive function, and delirium recurrence rates were similar across groups. Age, severe cardiopulmonary disease, APACHE II scores, dexmedetomidine dosage, minimum RASS score and sedative combination rates were associated with adverse effects of dexmedetomidine. Conclusion: Dexmedetomidine was more effective in delirium control but had a higher rate of adverse effects than olanzapine. Funding Statement: This work was supported by the Open Project Program of Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education [grant numbers 2019GDND03] and Youth Research Project of Dalian Municipal Central Hospital [grant numbers No. 2018A08]. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study was approved by the ethics committee of the Dalian Central Municipal Hospital.