Matching measured characteristics does not turn an observational comparison into a randomized trial.
The study analyzed 826 matched pairs of older noncardiac-surgery patients admitted to intensive care. Delirium occurred in about 9.3% with remimazolam and 11.3% without it. The adjusted association was not statistically clear, with an odds-ratio interval crossing one.
Residual differences in treatment selection, illness and co-medications can remain after matching. Other medication associations in the model are also observational, not proof of preventive or harmful effects. A nonsignificant result does not establish equal risk.
Report the uncertainty alongside the numerical difference. This study cannot establish that an individual delirium episode was prevented or caused by one intraoperative drug. Baseline vulnerability, surgical factors, infection, pain, sleep and the subsequent medication course remain part of an individualized assessment.
Source: PMC12358149, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: Lorazepam and Absent Postictal EEG Suppression in One Patient Did Not Establish SUDEP Prevention.