Delirium Subtypes and Associated Characteristics in Older Patients With Exacerbation of Chronic Conditions

Gual, Neus; Inzitari, Marco; Carrizo, G.; Calle, Alicia; Udina, Cristina; Yuste, A.; Morandi, Alessandro

doi:10.1016/j.jagp.2018.07.003

Cited by 27 publications

(20 citation statements)

References 39 publications

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“…Hypoactive delirium was the most common subtype reported by Krewulak et al [2]. In Gual's study, hyperactive delirium was the most common subtype [26]. In our study, the hypoactive delirium was the major subtype, hyperactive delirium was in the middle, and mixed delirium was the lowest one.…”

Section: Discussionsupporting

confidence: 59%

Incidence, Characteristics and Outcomes of Delirium in Patients With Noninvasive Ventilation: A Prospective Observational Study

Zhang

Bai

Han

et al. 2020

Preprint

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Background: Knowledge of delirium in noninvasive ventilation (NIV) is lacking. We aimed to report the incidence, characteristics and outcomes of delirium in NIV patients. Methods: A prospective observational study was performed in an intensive care unit (ICU) of a teaching hospital. Patients who used NIV as a fist-line intervention were enrolled. During NIV intervention, delirium was screened using Confusion Assessment Method for the ICU every day. Results: We enrolled 1083 patients. Of them, 196 patients (18.1%) experienced delirium during NIV intervention. Patients with delirium had higher NIV failure rates (37.8% vs. 21.0%, p ＜0.01), higher ICU mortality (33.2% vs. 14.3%, p ＜0.01) and higher hospital mortality (37.2% vs. 17.0%, p ＜0.01) than the subjects without delirium. They also spent longer time on NIV (median 6.3 vs. 3.7 days, p ＜0.01), and stayed longer in ICU (median 9.0 vs. 6.0 days, p ＜0.01) and hospital (median 14.5 vs. 11.0 days, p ＜0.01). Furthermore, delirium was independently associated with NIV failure, ICU mortality and hospital mortality (OR =1.97, 2.58 and 2.55, respectively; all p values ＜0.01). These results were confirmed in COPD and non-COPD cohorts. Compared with hyperactive delirium patients, the NIV days was longer in hypoactive delirium patients and much longer in mixed delirium patients (median 3.4 vs. 6.5 vs. 10.1 days, p ＜0.01). Similar outcomes were found in the length of stay in ICU and hospital. However, the NIV failure, ICU mortality and hospital mortality did not differ between three subtypes of delirium.Conclusions: Delirium increases the NIV failure rates, elevates the ICU and hospital mortality, prolongs the NIV days, and lengthens the ICU and hospital stay. Mixed delirium patients use more ICU resources than hypoactive delirium patients and much more than hyperactive delirium patients.

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Section: Discussionsupporting

confidence: 59%

Incidence, Characteristics and Outcomes of Delirium in Patients With Noninvasive Ventilation: A Prospective Observational Study

Zhang

Bai

Han

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Just as other brain disorders have been subtyped into various domains, such as phenotype (in mood disorders), neuropathological findings (in dementias) or aetiology (in strokes), some groups have categorized delirium on the basis of various features, such as the predominant motor activity subtype (hypoactive, hyperactive or mixed) 346 or the aetiology, including hypoxia, sepsis, sedative exposure or metabolic dysfunction (for example, renal or hepatic dysfunction) 81 . Both of these schemas have been useful for prognostication, with hypoactive delirium being associated with worse outcomes, including higher mortality, longer lengths of stay, increased number of falls and institutionalization as well as a lower QOL 76,[346][347][348][349][350][351][352] . Delirium associated with sedatives, sepsis and hypoxia has been correlated with worse cognitive functioning at 1 year after the delirium event 81 .…”

Section: Delirium Categorizationmentioning

confidence: 99%

Delirium

Wilson

Mart

Cunningham

et al. 2020

Nat Rev Dis Primers

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602

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“…confidence interval (CI), 1.199-7.133; p = 0.011)] was observed to be the most significant factor related to the incidence of delirium (Table 3). [20] have reported that the proportion of hypoactive, hyperactive, and mixed type delirium in older vulnerable patients with chronic conditions was 25.9%, 40.6%, and 31%, respectively. In another study, Marcantonio et al [21] reported that the psychomotor types of delirium after hip surgery in the elderly and the pure hypoactive type accounted for 71%of the patients.…”

Section: Resultsmentioning

confidence: 99%

The Incidence and Impact of Abdominal Surgery on Delirium in Abdominal Trauma Patients

Roh

Park

et al. 2020

J Acute Care Surg

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Purpose: The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. Methods: Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. Results: Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium Conclusion: This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

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Delirium Subtypes and Associated Characteristics in Older Patients With Exacerbation of Chronic Conditions

Cited by 27 publications

References 39 publications

Incidence, Characteristics and Outcomes of Delirium in Patients With Noninvasive Ventilation: A Prospective Observational Study

Incidence, Characteristics and Outcomes of Delirium in Patients With Noninvasive Ventilation: A Prospective Observational Study

Delirium

The Incidence and Impact of Abdominal Surgery on Delirium in Abdominal Trauma Patients

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