Morphine usage in elderly patients with acute decompensated heart failure / 中华老年医学杂志

ABSTRACT

Objective To explore morphine usage in emergency department (ED) and its effect on outcome in elderly patients with acute decompensated heart failure (ADHF) in a single Chinese center. Methods A prospective observational analysis was performed in elderly patients aged 65-99years with newly diagnosed ADHF, who were treated and admitted from ED of our hospital. The data including patients' demographic characters, past medical history, initial presentations and medication taking were collected and analyzed. According to using morphine or not, the patients were divided into two groups. The effects of morphine on mechanical ventilation, hospitalization stay and in-hospital mortality were also evaluated. Results The 82 patients were enrolled in this study, 52 males and 30females. In the 41 (50. 0%) patients using morphine (morphine usage group), the foregone incidence rates of coronary heart disease, type 2 diabetes mellitus and stroke were less, the levels of troponin T and random blood sugar were increased in morphine usage group than in non-morphine usage group.No other differences were found in initial presentations between the two groups. The patients often theophylline before morphine administration. And they had a higher prevalence of mechanical ventilation (95%CI 1.22-7.41), but no differences were found in hospitalization stay and in-hospital mortality between the two groups. Conclusions Morphine is still as a common medicine in treatment of ADHF in ED. Morphine usage can increase prevalence of mechanical ventilation without influencing hospitalization stay and in-hospital mortality even in elderly ADHF patients. Morphine may be a safe medication in the rational treatment of early-stage ADHF in elderly patients with mechanical ventilation support.