Incidence, risk factors, and cumulative risk of delirium among ICU patients: A case-control study

Pan, Yu; Yan, Jianlong; Jiang, Zhixia; Luo, Jing; Zhang, Jingjing; Yang, Kaihan

doi:10.1016/j.ijnss.2019.05.008

Cited by 15 publications

(14 citation statements)

References 27 publications

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“…e second possible explanation is sleep deprivation [43] caused by pain, discomfort, anxiety, noise, light, and ICU care-related activities [44]. Previous studies supported that ventilator use is a significant risk factor for developing delirium [4,36,38,45,46]. Results of the current study are consistent with the previous studies [13,14,47,48] where metabolic acidosis was significantly associated with delirium development.…”

Section: Discussionsupporting

confidence: 89%

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Incidence, Associated Factors, and Outcome of Delirium among Patients Admitted to ICUs in Oman

Al-Hoodar

Lazarus

Omari

et al. 2022

Critical Care Research and Practice

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Background. The incidence of delirium is high up to 46.3% among patients admitted to ICU. Delirium is linked to negative patient outcomes like increased duration of mechanical ventilation use, prolonged ICU stay, increased mortality rate, and healthcare costs. Despite the importance of delirium and its consequences that are significant, there is a scarcity of studies which explored delirium in Oman. Objectives. This study was conducted to assess the incidence of delirium, the association between the selected predisposing factors and precipitating factors with delirium, determine the predicators of delirium, and evaluate its impacts on ICU mortality and ICU length of stay among ICU patients in Oman. Methods. A multicenter prospective observational design was used. A total of 153 patients were assessed two-times a day by bedside ICU nurses through the Intensive Care Delirium Screening Checklist (ICDSC). Results. The results revealed that the delirium incidence was 26.1%. Regression analysis showed that sepsis, metabolic acidosis, nasogastric tube use, and APACHE II score were independent predictors for delirium among ICU patients in Oman and delirium had significant impacts on ICU length of stay and mortality rate. Conclusion. Delirium is common among ICU patients and it is associated with negative consequences. Multidisciplinary prevention strategies should be implemented to identify and treat the modifiable risk factors.

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Section: Discussionsupporting

confidence: 89%

“…Patients with severe illness and organ dysfunction may face a higher risk of developing delirium and indicating that delirium was associated with serious conditions. is study identifies sedative drugs use as precipitating factors as reported in prior studies [18,[38][39][40][41].…”

Section: Discussionmentioning

confidence: 82%

Incidence, Associated Factors, and Outcome of Delirium among Patients Admitted to ICUs in Oman

Al-Hoodar

Lazarus

Omari

et al. 2022

Critical Care Research and Practice

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“…In the ICU, multiple delirium risk factors are often present and can increase risk in an additive manner. 7 Delirium is also associated with prolonged hospitalisation, long-term cognitive and functional impairment and increased mortality. 8–10 As such, there is a critical need to improve understanding of this syndrome in patients with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Delirium and neuropsychological outcomes in critically Ill patients with COVID-19: a cohort study

et al. 2021

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ObjectiveTo characterise the clinical course of delirium for patients with COVID-19 in the intensive care unit, including postdischarge neuropsychological outcomes.DesignRetrospective chart review and prospective survey study.SettingIntensive care units, large academic tertiary-care centre (USA).ParticipantsPatients (n=148) with COVID-19 admitted to an intensive care unit at Michigan Medicine between 1 March 2020 and 31 May 2020 were eligible for inclusion.Primary and secondary outcome measuresDelirium was the primary outcome, assessed via validated chart review method. Secondary outcomes included measures related to delirium, such as delirium duration, antipsychotic use, length of hospital and intensive care unit stay, inflammatory markers and final disposition. Neuroimaging data were also collected. Finally, a telephone survey was conducted between 1 and 2 months after discharge to determine neuropsychological function via the following tests: Family Confusion Assessment Method, Short Blessed Test, Patient-Reported Outcomes Measurement Information System Cognitive Abilities 4a and Patient-Health Questionnaire-9.ResultsDelirium was identified in 108/148 (73%) patients, with median (IQR) duration lasting 10 (4–17) days. In the delirium cohort, 50% (54/108) of patients were African American and delirious patients were more likely to be female (76/108, 70%) (absolute standardised differences >0.30). Sedation regimens, inflammation, delirium prevention protocol deviations and hypoxic-ischaemic injury were likely contributing factors, and the most common disposition for delirious patients was a skilled care facility (41/108, 38%). Among patients who were delirious during hospitalisation, 4/17 (24%) later screened positive for delirium at home based on caretaker assessment, 5/22 (23%) demonstrated signs of questionable cognitive impairment or cognitive impairment consistent with dementia and 3/25 (12%) screened positive for depression within 2 months after discharge.ConclusionPatients with COVID-19 commonly experience a prolonged course of delirium in the intensive care unit, likely with multiple contributing factors. Furthermore, neuropsychological impairment may persist after discharge.

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“…Moreover, the habitual use of sleeping pills (especially benzodiazepines) is reported as a risk factor for POD [ 32 ], which supports our conclusions. Additionally, a previous study indicates that prolonged ICU hospitalization is positively associated with delirium among ICU patients [ 33 ]. All these studies are quite in accordance with our results.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and a nomogram model for postoperative delirium in elderly gastric cancer patients after laparoscopic gastrectomy

Chen

Xing

2022

World J Surg Onc

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Background To evaluate the risk factors of postoperative delirium (POD) in elderly gastric cancer (GC) patients after laparoscopic gastrectomy and construct a predictive model. Methods Elderly GC patients undergoing laparoscopic gastrectomy were enrolled and grouped based on the status of POD development within postoperative 7 days. Independent risk factors were selected out by univariate and multivariate logistic regression analyses and then enrolled in the nomogram prediction model. Results A total of 270 elderly GC patients were enrolled, and POD occurred in 74 (27.4%) patients within postoperative 7 days. The results of multivariate regression analysis indicated that age (OR: 3.30, 95% CI: 1.41–6.85, P < 0.001), sleeping pills (OR: 1.87, 95% CI: 1.12–3.09, P = 0.012), duration of ICU stay (OR: 1.55, 95% CI: 1.02–2.37, P = 0.029), albumin/fibrinogen ratio (AFR) (OR: 1.74, 95% CI: 1.03–2.76, P = 0.019), and neutrophils/lymphocytes ratio (NLR) (OR: 2.12, 95% CI: 1.11–4.01, P = 0.016) were five independent risk factors for POD in elderly GC patients. The AUC of the constructed nomogram model based on these five factors was 0.807. Conclusions This study highlighted that age, AFR, NLR, sleeping pills taking, and duration of ICU stay were independent risk factors for POD, and the nomogram model based on these factors could effectively predict POD in elderly GC patients.

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Incidence, risk factors, and cumulative risk of delirium among ICU patients: A case-control study

Cited by 15 publications

References 27 publications

Incidence, Associated Factors, and Outcome of Delirium among Patients Admitted to ICUs in Oman

Incidence, Associated Factors, and Outcome of Delirium among Patients Admitted to ICUs in Oman

Delirium and neuropsychological outcomes in critically Ill patients with COVID-19: a cohort study

Risk factors and a nomogram model for postoperative delirium in elderly gastric cancer patients after laparoscopic gastrectomy

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