Underestimating hypoactive delirium?

Hoshino, Haruhiko; Watanabe, Jun; Banno, Masahiro

doi:10.1007/s00540-020-02833-4

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Our study show that hypoactive delirium is a predominant subtype in no-traumatic associated ARDS patients, the clinical symptoms of hypoactive delirium are characterized by drowsiness, apathy, and scanty speech, giving the physician an illusion of "stable condition" [9,11]. So, early effective and rapid detection of delirium appears particularly important.…”

Section: Discussionmentioning

confidence: 72%

“…ARDS patients with hypoactive delirium are often simply considered the patients sleepy or drowsy because of their age, hypoxemia, or medication use. Compared with other two subtypes, hypoactive delirium is "quiet", the clinical symptoms of hypoactive delirium are not obvious, and it is easy to miss the diagnosis and misdiagnosis [8,9]. A study founded that almost all survivors of ARDS have delirium symptoms, and even 80% of patients have memory loss, di culty concentrating, and decreased reaction speed a year later [10].Hypoactive delirium is associated with poorer outcomes, one study reported that 75% of the cases of hypoactive delirium were missed [11].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for hypoactive delirium in patients with non-traumatic ARDS：a prospective, observational study

Fan

Tang

et al. 2023

Preprint

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Aims and Objective: To investigate the incidence, characteristics and risk factors for hypoactive delirium in patients with non-traumatic ARDS.Background Hypoactive delirium is a known serious complication in ARDS patients and currently there are no effective early detection models and clinical prediction tools, lack of clinical treatment.Methods The study was conducted with non-traumatic ARDS patients who stayed in the ICU for more than 24 hours and were older than 18 years. 205 ARDS patients admitted to ICU in Gansu Provincial People's Hospital from December 2021 to February 2023 were selected. Demographic, clinical characteristics and laboratory test indicators were collected within 24 h after the patient entered the ICU. A multivariate logistic regression analysis was used to investigate risk factors, at the same times evaluate the clinical prediction effect of the model and draw a Nomogram for visual display.Results The incidence of hypoactive delirium among patients included in the study was 41%. Patients with hypoactive delirium were hypertension, diabetes mellitus, APACHE II score ≥ 15, higher procalcitonin, higher CRP, higher lactic dehydrogenase and higher IL-6 than those without hypoactive delirium. The logistic regression analysis results revealed that diabetes mellitus (OR 3.305, 95% CI: 1.866–12.616; p = 0.047), CRP (OR 1.002, 95% CI: 1.001–1.023; p = 0.044), IL-6 (OR 1.045, 95% CI: 1.017–1.063; p = 0.001) were independent risk factors of hypoactive delirium. After ROC, Calibration plot and Decision Curve Analysis (DCA) confirmed that the clinical prediction of this study model was satisfactory, and a nomogram were drawn for visual display.Conclusions Hypoactive delirium is a common serious complication in non-traumatic ARDS patients. Our logistic regression model not only effectively predicts hypoactive delirium early, but also excavates potential clinical therapeutic targets.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Risk factors for hypoactive delirium in patients with non-traumatic ARDS：a prospective, observational study

Fan

Tang

et al. 2023

Preprint

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“…Our study revealed that hypoactive delirium is a predominant subtype of delirium in ARDS patients without trauma. The clinical symptoms of hypoactive delirium are characterized by drowsiness, apathy, and little speech, giving physicians the impression of a stable condition 9 , 11 . Therefore, early, effective and rapid detection of delirium is particularly important.…”

Section: Discussionmentioning

confidence: 99%

“…ARDS patients with hypoactive delirium are often considered to be sleepy or drowsy because of their age, hypoxemia, or medication use. Compared with the other two subtypes, hypoactive delirium is “quiet”; the clinical symptoms of hypoactive delirium are not obvious, and it is easily undiagnosed or misdiagnosed 8 , 9 . A study revealed that almost all survivors of ARDS have symptoms of delirium, and 80% of patients experience memory loss, difficulty concentrating, and decreased reaction speed even 1 year later 10 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for hypoactive delirium in patients with nontraumatic ARDS: a prospective observational study

Lian,

Li,

Tang

et al. 2024

Sci Rep

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To investigate the incidence, characteristics and risk factors for hypoactive delirium in patients with nontraumatic acute respiratory distress syndrome (ARDS) and to explore the independent risk factors associated with hypoactive delirium and provide new ideas for early prediction and treatment. Hypoactive delirium is a known serious complication in ARDS patients, and currently, there are no effective early detection models or clinical prediction tools, and there is a lack of clinical treatment. This study included nontraumatic ARDS patients who stayed in the intensive care unit (ICU) for more than 24 h and were older than 18 years. A total of 205 ARDS patients admitted to the ICU of Gansu Provincial People's Hospital between December 2021 and February 2023 were selected. Demographic data, clinical characteristics and laboratory test results were collected within 24 h after the patients entered the ICU. Multivariate logistic regression analysis was used to investigate risk factors, evaluate the clinical prediction effect of the model and construct a nomogram for visual display. The incidence of hypoactive delirium among the patients included in the study was 41%. Patients with hypoactive delirium had hypertension; diabetes mellitus; Acute Physiology and Chronic Health Evaluation II (APACHE II) scores ≥ 15; and increased procalcitonin, C-reactive protein (CRP), lactic dehydrogenase and interleukin-6 (IL-6) levels compared with those without hypoactive delirium. Logistic regression analysis revealed that diabetes mellitus (OR 3.305, 95% CI: 1.866–12.616; p = 0.047), CRP level (OR 1.002, 95% CI: 1.001–1.023; p = 0.044), and IL-6 level (OR 1.045, 95% CI: 1.017–1.063; p = 0.001) were independent risk factors for hypoactive delirium. After receiver operating characteristic (ROC) curve analysis, calibration plot and decision curve analysis (DCA) confirmed that the clinical prediction ability of this study model was satisfactory, and a nomogram was drawn for visual display. Hypoactive delirium is a common serious complication in nontraumatic ARDS patients. Our logistic regression model not only effectively predicts hypoactive delirium early but also reveals potential clinical therapeutic targets.

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