Differences in long-term outcomes between ICU patients with persistent delirium, non-persistent delirium and no delirium: A longitudinal cohort study

Heijden, Emma F.M. van der; Kooken, Rens; Zegers, Marieke; Simons, Koen S.; Boogaard, Mark van den

doi:10.1016/j.jcrc.2023.154277

Cited by 10 publications

(5 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several Dutch observational studies using EQ-5D-5L to explore HRQoL have reported an association between ICU delirium and worse long-term HRQoL [45,46], while other studies found no association [40,42]. Two of these observational studies reported HRQoL levels, which are in line with the HRQoL levels of this study.…”

Section: Health-related Quality Of Lifesupporting

confidence: 87%

See 1 more Smart Citation

Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium

Mortensen,

Andersen-Ranberg,

Poulsen

et al. 2024

Intensive Care Med

View full text Add to dashboard Cite

Purpose:We assessed long-term outcomes in acutely admitted adult patients with delirium treated in intensive care unit (ICU) with haloperidol versus placebo. Methods:We conducted pre-planned analyses of 1-year outcomes in the Agents Intervening against Delirium in the ICU (AID-ICU) trial, including mortality and health-related quality of life (HRQoL) assessed by Euroqol (EQ) 5-dimension 5-level questionnaire (EQ-5D-5L) index values and EQ visual analogue scale (EQ VAS) (deceased patients were assigned the numeric value zero). Outcomes were analysed using logistic and linear regressions with bootstrapping and G-computation, all with adjustment for the stratification variables (site and delirium motor subtype) and multiple imputations for missing HRQoL values.Results: At 1-year follow-up, we obtained vital status for 96.2% and HRQoL data for 83.3% of the 1000 randomised patients. One-year mortality was 224/501 (44.7%) in the haloperidol group versus 251/486 (51.6%) in the placebo group, with an adjusted absolute risk difference of − 6.4%-points (95% confidence interval [CI] − 12.8%-points to − 0.2%-points; P = 0.045). These results were largely consistent across the secondary analyses. For HRQoL, the adjusted mean differences were 0.04 (95% CI − 0.03 to 0.11; P = 0.091) for EQ-5D-5L-5L index values, and 3.3 (95% CI − 9.3 to 17.5; P = 0.142) for EQ VAS. Conclusions:In acutely admitted adult ICU patients with delirium, haloperidol treatment reduced mortality at 1-year follow-up, but did not statistically significantly improve HRQoL.

show abstract

Section: Health-related Quality Of Lifesupporting

confidence: 87%

“…Two of these observational studies reported HRQoL levels, which are in line with the HRQoL levels of this study. However, major differences exist between research design, use of restraints, duration of mechanical ventilation and age, and no studies used EQ VAS, making further comparison difficult [40,45].…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium

Mortensen,

Andersen-Ranberg,

Poulsen

et al. 2024

Intensive Care Med

View full text Add to dashboard Cite

show abstract

“…Als spezifischer Risikofaktor für das Auftreten von kognitiven Störungen ist vor allem die Sedierung anzuführen, die eine der wesentlichen Ursachen des Intensivdelirs darstellt, dem zentralen Faktor für das Auftreten langfristiger kognitiver Beeinträchtigungen [15]. Dabei spielen die Tiefe, Dauer, das Muster der Sedierung und die verwendeten Medikamente, insbesondere Benzodiazepine, eine Rolle.…”

Section: Merke Als Schwerwiegendste Kognitive Störung Ist Das Neueunclassified

Langzeitfolgen nach Intensivtherapie

Druml,

Buchtele,

Staudinger

2024

Dtsch Med Wochenschr

View full text Add to dashboard Cite

“…Duration of delirium, with a median [IQR] typically around 2 [1–7] days in a general ICU population [141] and 4 [2–7] days in patients with respiratory/circulatory failure, also reflect severity of brain dysfunction and predicts long-term cognitive outcomes, with prolonged durations associated with more severe cognitive impairment up to a year later [22]. Specifically, prolonged delirium (>14 days) is associated with older and sicker patients [142] and deleterious short- and long-term outcome [143] but also strongly with the use of physical restraint, indicating that ICU care could be improved.…”

Section: Deliriummentioning

confidence: 99%

Acute encephalopathy in the ICU: a practical approach

Kurtz,

van den Boogaard,

Girard

et al. 2024

Current Opinion in Critical Care

Self Cite

View full text Add to dashboard Cite

Purpose of review Acute encephalopathy (AE) – which frequently develops in critically ill patients with and without primary brain injury – is defined as an acute process that evolves rapidly and leads to changes in baseline cognitive status, ranging from delirium to coma. The diagnosis, monitoring, and management of AE is challenging. Here, we discuss advances in definitions, diagnostic approaches, therapeutic options, and implications to outcomes of the clinical spectrum of AE in ICU patients without primary brain injury. Recent findings Understanding and definitions of delirium and coma have evolved. Delirium is a neurocognitive disorder involving impairment of attention and cognition, usually fluctuating, and developing over hours to days. Coma is a state of unresponsiveness, with absence of command following, intelligible speech, or visual pursuit, with no imaging or neurophysiological evidence of cognitive motor dissociation. The CAM-ICU(−7) and the ICDSC are validated, guideline-recommended tools for clinical delirium assessment, with identification of clinical subtypes and stratification of severity. In comatose patients, the roles of continuous EEG monitoring and neuroimaging have grown for the early detection of secondary brain injury and treatment of reversible causes. Summary Evidence-based pharmacologic treatments for delirium are limited. Dexmedetomidine is effective for mechanically ventilated patients with delirium, while haloperidol has minimal effect of delirium but may have other benefits. Specific treatments for coma in nonprimary brain injury are still lacking.

show abstract

Differences in long-term outcomes between ICU patients with persistent delirium, non-persistent delirium and no delirium: A longitudinal cohort study

Cited by 10 publications

References 43 publications

Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium

Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium

Langzeitfolgen nach Intensivtherapie

Acute encephalopathy in the ICU: a practical approach

Contact Info

Product

Resources

About