Risk Factors for Delirium and Association of Antipsychotic Use with Delirium Progression in Critically Ill Trauma Patients

Shoulders, Bethany; Elsabagh, Sarah; Tam, Douglas J.; Frantz, Amanda; Alexander, Kaitlin M.; Voils, Stacy A.

doi:10.1177/00031348211069792

Cited by 3 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of delirium in trauma patients admitted to the ICU has been reported as up to 67%, with increased risk for the elderly and those requiring mechanical ventilation [11 ▪ ].…”

Section: Delirium Definition Presentation and Incidencementioning

confidence: 99%

“…Trauma serves as an independent risk factor for developing delirium among the critically ill population [11 ▪ ]. Nonmodifiable and modifiable risk factors supported by recent studies are summarized in Table 1.…”

Section: Elderly Patients With Rib Fracturesmentioning

confidence: 99%

“…Antipsychotic medications have long been a mainstay of treatment for hyperactive delirium, despite multiple studies showing increased rates or duration of delirium associated with antipsychotic use [11 ▪ ,25 ▪ ]. Current SCCM practice guidelines recommend against the use of haloperidol or other typical antipsychotics for either use or treatment of delirium.…”

Section: Elderly Patients With Rib Fracturesmentioning

confidence: 99%

See 2 more Smart Citations

Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

Williams

Estime

Kuza

2023

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

Purpose of reviewThis article reviews the impact and importance of delirium on patients admitted to the ICU after trauma, including the latest work on prevention and treatment of this condition. As the population ages, the incidence of geriatric trauma will continue to increase with a concomitant rise in the patient and healthcare costs of delirium in this population.Recent findingsRecent studies have further defined the risk factors for delirium in the trauma ICU patient population, as well as better demonstrated the poor outcomes associated with the diagnosis of delirium in these patients. Recent trials and meta-analysis offer some new evidence for the use of dexmedetomidine and quetiapine as preferred agents for prevention and treatment of delirium and add music interventions as a promising part of nonpharmacologic bundles.SummaryTrauma patients requiring admission to the ICU are at significant risk of developing delirium, an acute neuropsychiatric disorder associated with increased healthcare costs and worse outcomes including increased mortality. Ideal methods for prevention and treatment of delirium are not well established, especially in this population, but recent research helps to clarify optimal prevention and treatment strategies.

show abstract

“…The incidence of delirium in trauma patients admitted to the ICU has been reported as up to 67%, with increased risk for the elderly and those requiring mechanical ventilation [11 ▪ ].…”

Section: Delirium Definition Presentation and Incidencementioning

confidence: 99%

Section: Elderly Patients With Rib Fracturesmentioning

confidence: 99%

Section: Elderly Patients With Rib Fracturesmentioning

confidence: 99%

See 1 more Smart Citation

Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

Williams

Estime

Kuza

2023

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

show abstract

“…Previous research also highlighted the presence of COPD as a significant risk factor in the development of delirium [ 13 ], and the underlying mechanism may be related to chronic hypoxia that promotes brain dysfunction and cognitive decline [ 14 , 15 ]. Furthermore, trauma was suggested to serve as a predisposition for delirium [ 16 ]. Recent evidence recognized that nutrition played a critical role in the development of delirium.…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of the Prognostic Nutritional Index in Predicting Delirium among Critically Ill Patients: A Retrospective Cohort Study

Xu,

Zhong

2024

Critical Care Research and Practice

View full text Add to dashboard Cite

Delirium is a serious and complex problem facing critically ill patients. This retrospective study aimed to explore the association between prognostic nutrition index (PNI) and delirium in critically ill patients in the intensive care unit (ICU). This study was based on the Medical Information Mart Intensive Care IV (MIMIC IV) database. Patients over 18 years of age were enrolled. Univariate and multivariate logistic regression analyses were performed to explore the association between PNI and delirium. Tendency analysis, subgroups analysis, and restricted cubic spline (RCS) were selected to further certify the association. The receiver operating characteristic curve (ROC) was adopted to assess the predictability of PNI to delirium. Propensity score matching (PSM) was used to reduce the interference of confounders. A total of 3,105 patients participated in this study. As the grade of malnutrition increases, the incidence of delirium increases in all models. The odds ratios (OR) of delirium in the fully adjusted model were 1.00 (reference), 1.04 (0.80, 1.36), 1.53 (1.17, 1.99), and 1.93 (1.44, 2.59). Strong U-shaped curves were found with RCS analysis between delirium and PNI in the subgroups of patients over 60 years of age and patients with chronic obstructive pulmonary disease (COPD). After PSM, the ORs of delirium were 1.44 (1.16, 1.79) and 1.53 (1.22, 1.93), respectively, in the univariate and multivariate logistic regression models. PNI is negatively associated with the prevalence of delirium in critically ill adults in the ICU. PNI is an independent risk factor for the incidence of delirium in adults in the ICU.

show abstract

High level of systemic immune inflammation index elevates delirium risk among patients in intensive care unit

Xu,

Zhang,

Zhang

2024

Sci Rep

View full text Add to dashboard Cite

Evidence regarding the effect of systemic immune-inflammation index on delirium occurrence is limited. This study aimed to investigate the association between SII and delirium in intensive care unit (ICU) patients. Methods: Information was extracted from Medical Information Mart for Intensive Care-IV. Four logistic regression model was established and incorporated with subgroup analysis and restricted cubic spline (RCS). The cutoff value of SII was acquired from receiver operator characteristic curve (ROC), and propensity score matching (PSM) was utilized to attenuate the confounding effect. Survival analysis was utilized to evaluate the relationship between SII and 30-day or 90-day all-cause mortality. Results: Among the 7,518 participants, 1,685 cases of delirium occurred. Individuals in the highest quartile of SII exhibited a heightened delirium risk, with a significant multivariable-adjusted odds ratio (OR) of 3.12(2.24,4.33). Tendency analysis, subgroup analysis and PSM together confirmed the positive relationship. Results of Cox regression displayed the risk of both 30-day and 90-day mortality increased about 50% in the higher-SII group. Conclusion: Higher levels of SII is positively associated with the occurrence of delirium and increased all-cause mortality risk.

show abstract

Risk Factors for Delirium and Association of Antipsychotic Use with Delirium Progression in Critically Ill Trauma Patients

Cited by 3 publications

References 25 publications

Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

Clinical Significance of the Prognostic Nutritional Index in Predicting Delirium among Critically Ill Patients: A Retrospective Cohort Study

High level of systemic immune inflammation index elevates delirium risk among patients in intensive care unit

Contact Info

Product

Resources

About