Long-term prognostic value of delirium in elderly patients with acute cardiac diseases admitted to two cardiac intensive care units: a prospective study (DELIRIUM CORDIS)

Abstract

Delirium is a common complication in elderly CICU patients, and is associated with a longer and more complicated hospital stay and increased short and long-term mortality. Our findings suggest the usefulness of a protocol for the early identification of delirium in the CICU. Clinicaltrials.gov: NCT02004665.

Impact of delirium on patients hospitalized for myocardial infarction: A propensity score analysis of the National Inpatient Sample

“…For example, in the cardiac intensive care unit (ICU), delirium in patients 85 years old and above was present in 54% of subjects. [14][15][16] There were more comorbid conditions in the delirium group. The median Charlson index was 3 compared to 2 in the control group.…”

“…Studies on elderly patients with acute coronary syndrome reported high rates of delirium, especially in critical‐care settings. For example, in the cardiac intensive care unit (ICU), delirium in patients 85 years old and above was present in 54% of subjects …”

“…To the best of our best knowledge, this is the largest study that examined the association of delirium with worse in‐hospital clinical outcomes in patients with MI. Previous studies examined the impact of delirium in limited populations, including those with cardiogenic shock, in the cardiac ICU, undergoing transcatheter aortic valve replacement, or CABG, with an emphasis on elderly populations . The analysis used the strength of the NIS, with large sample sizes and the ability to adjust for several confounding variables.…”

“…Previous studies examined the impact of delirium in limited populations, including those with cardiogenic shock, in the cardiac ICU, undergoing transcatheter aortic valve replacement, or CABG, with an emphasis on elderly populations. 16,18,[30][31][32] The analysis used the strength of the NIS, with large sample sizes and the ability to adjust for several confounding variables. We used 2 widely used methods, multivariable logistic regression and propensity score matching analysis, to adjust for confounding variables that affect both the outcome and the presence of the delirium.…”

Delirium in the Cardiac Intensive Care Unit

“…A recent prospective study of 726 European CICU patients reported that 15% of these patients were diagnosed with delirium during their hospital stay, a rate which was 50% in patients over the age of 85 years. 29 Another prospective study of 309 patients admitted to the CICU, found a 19% prevalence of delirium, with a 2-month incidence rate of 9% among those who were free of delirium at baseline. 30 Similarly, in the largest prospective study to date by Naksuk et al, the incidence rate of delirium among 11 079 patients was 8% while in the CICU.…”