Delirium in a Latin American intensive care unit. A prospective cohort study of mechanically ventilated patients

Abstract

ObjectiveTo establish the prevalence of delirium in a general intensive care unit and to identify associated factors, clinical expression and the influence on outcomes.MethodsThis was a prospective cohort study in a medical surgical intensive care unit. The Richmond Agitation-Sedation Scale and Confusion Assessment Method for the Intensive Care Unit were used daily to identify delirium in mechanically ventilated patients.ResultsIn this series, delirium prevalence was 80% (N = 184 delirious patients out of 230 patients). The number of patients according to delirium psychomotor subtypes was as follows: 11 hyperactive patients (6%), 9 hypoactive patients (5%) and 160 mixed patients (89%). Multiple logistic regression modeling using delirium as the dependent outcome variable (to study the risk factors for delirium) revealed that age > 65 years, history of alcohol consumption, and number of mechanical ventilation days were independent variables associated with the development of delirium. The multiple logistic regression model using hospital mortality as the dependent outcome variable (to study the risk factors for death) showed that severity of illness, according to the Acute Physiology and Chronic Health Evaluation II, mechanical ventilation for more than 7 days, and sedation days were all independent predictors for excess hospital mortality.ConclusionThis Latin American prospective cohort investigation confirmed specific factors important for the development of delirium and the outcome of death among general intensive care unit patients. In both analyses, we found that the duration of mechanical ventilation was a predictor of untoward outcomes.

Assessment of delirium using the PRE-DELIRIC model in an intensive care unit in Argentina

“…Depending on the patient population and ICU type, the incidence of delirium reported in the literature varies significantly, ranging from 16% to 80%. ( 3 , 17 ) The incidence of delirium in our study agrees with the results of an international study from Latin America that included Argentina. ( 19 ) In other Argentine studies, the incidence of delirium was 43.3% in elderly hospitalized patients and 10.8% in adult patients admitted to the general ward.…”

“…( 14 - 16 ) Few studies have examined the incidence of delirium and its risk factors in the Argentinean population, and no studies have used PRE-DELIRIC to study Latin American populations. ( 17 )…”

Redução do tempo de internação em Unidade de Terapia Intensiva associado à assistência de enfermagem: Revisão integrativa da literatura

“…Estudos também apontam a utilização de intervenções simples na prevenção do Delirium, como chamar os pacientes pelo primeiro nome, informar sobre o local de internação e a evolução do seu quadro clínico. (Mori et al, 2016;Mesa et al, 2017).…”

Delirium em CTI: ansiedade e depressão como possíveis fatores de risco na população idosa

“…O segundo observa-se em pacientes pouco responsivos, apáticos, com atividade motora diminuída, falta de coerência na fala e desinteresse. Já a combinação dos dois tipos é, então, o misto (Mesa et al, 2017).…”