Incidence and Risk Factors of Delirium in the Intensive Care Unit: A Prospective Cohort

Rahimi–Bashar, Farshid; Abolhasani, Ghazal; Manouchehrian, Nahid; Jiryaee, Nasrin; Vahedian‐Azimi, Amir; Sahebkar, Amirhossein

doi:10.1155/2021/6219678

Cited by 16 publications

(10 citation statements)

References 46 publications

(21 reference statements)

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“…The incidence of delirium in our study was 31.8% with the median onset of delirium being 3 (IQR = 2) days after admission. Although the incidence of delirium in our study was similar to previous studies reporting an incidence of 27–32% in ICU patients (Jayaswal et al, 2019; Ouimet et al, 2007; Rahimi‐Bashar et al, 2021), on the contrary, it was much lower than studies reported with an incidence of up to 80% (Ely, Gautam, et al, 2001; Ely, Margolin, et al, 2001; Girard et al, 2010; Shehabi et al, 2010). The reason for these differences can be explained by the characteristics or settings of the studies (e.g.…”

Section: Discussionsupporting

confidence: 91%

Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study

Erbay

Girgin

Kahveci

2022

Journal of Clinical Nursing

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Aims and Objective: To investigate the incidence, characteristics and risk factors of delirium in the ICU.Background: Identifying the risk factors of delirium is important for early detection and to prevent adverse consequences.Design: An observational cohort study conducted according to STROBE Guidelines. Method:The study was conducted with patients who stayed in ICU ≥24 h and were older than 18 years. Patients were assessed twice daily using the RASS and CAM-ICU until either discharge or death. Cumulative incidence was calculated. Demographic/clinical characteristics, length of stay and mortality were compared between patients with and without delirium. A logistic regression model was used to investigate risk factors. Results:The incidence of delirium was 31.8% and hypoactive type was the most frequent (41.5%). The median onset of delirium was 3 days (IQR = 2) with a mean duration of 5.27 ± 2.32 days. Patients with delirium were significantly older, had higher APACHE-II, SOFA and CPOT scores, higher blood urea levels, higher requirements for mechanical ventilation, sedation and physical restraints, longer stays in the ICU and higher mortality than those without delirium. The logistic regression analysis results revealed that a CPOT score ≥3 points (

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Section: Discussionsupporting

confidence: 91%

Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study

Erbay

Girgin

Kahveci

2022

Journal of Clinical Nursing

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“…APACHE II and SOFA scores represent illness severity and organ dysfunction, respectively. The APACHE II and SOFA scores in our study were 14.2 ± 5.7 and 8.4 ± 5.4, respectively, indicating severe illness in our patients and explaining the high incidence of delirium, which is supported by other studies (Rahimi-Bashar et al, 2021). We found that delirium was a frequent complication in older ICU patients, which was similar to previous studies (Tafelmeier et al, 2019;Eertmans et al, 2020).…”

Section: Figuresupporting

confidence: 91%

Early alteration of peripheral blood lymphocyte subsets as a risk factor for delirium in critically ill patients after cardiac surgery: A prospective observational study

Cheng²,

Zhang³

et al. 2022

Front. Aging Neurosci.

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ObjectiveThere is a high incidence of delirium among patients with organ dysfunction undergoing cardiac surgery who need critical care. This study aimed to explore the risk factors for delirium in critically ill patients undergoing cardiac surgery and the predictive value of related risk factors.MethodsWe conducted a prospective observational study on adult critically ill patients who underwent cardiac surgery between January 2019 and August 2021. Patients were consecutively assigned to delirium and non-delirium groups. Univariate analysis and multivariate logistic analysis were used to determine the risk factors for delirium. Receiver operating characteristic curves and a nomogram were used to identify the predictive value of related risk factors.ResultsDelirium developed in 242 of 379 (63.9%) participants. Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 14.2 ± 5.6 and 18 ± 8.4, respectively. Patients with delirium had longer cardiopulmonary bypass time (149.6 ± 59.1 vs. 126.7 ± 48.5 min, p < 0.001) and aortic cross-clamp time (98.7 ± 51.5 vs. 86.1 ± 41.6 min, p = 0.010) compared with the non-delirium group. The area under the curve was 0.824 for CD4+ T cell count and 0.862 for CD4/CD8 ratio. Multivariate analysis demonstrated that age [odds ratio (OR) 1.030, p = 0.038], duration of physical restraint (OR 1.030, p < 0.001), interleukin-6 (OR 1.001, p = 0.025), CD19+ B cell count (OR 0.996, p = 0.016), CD4+ T cell count (OR 1.005, p < 0.001) and CD4/CD8 ratio (OR 5.314, p < 0.001) were independent risk factors for delirium. A nomogram revealed that age, cardiopulmonary bypass duration, CD4+ T cell count and CD4/CD8 ratio were independent predictors of delirium.ConclusionAge, duration of physical restraint, CD4+ T cell count and CD4/CD8 ratio were reliable factors for predicting delirium in critically ill patients after cardiac surgery. The receiver operating characteristic curves and nomogram suggested a potential role for CD4+ T cells in mediating potential neuroinflammation of delirium.

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“…There was no significant difference in the incidence of delirium between patients with COVID-19 and those without COVID-19. Based on this, other factors were more likely involved in the development of delirium among patients admitted to the ICU.The GEE revealed that the CFS and SOFA scores upon ICU admission were significant indicators for the development of delirium, which is in line with the results of previous studies[6] [20]. Frail patients were reportedly more susceptible to stress, which results in inflammation, and they might be more likely to become delirious[18] [21].…”

supporting

confidence: 87%

Effects of Coronavirus Disease 2019 and Frailty on Delirium in the Intensive Care Unit: A Propensity Score Analysis

Yamanaka¹,

Ida²,

Kotani³

et al. 2023

OJAnes

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Purpose: The association between frailty and delirium has emerged as a research topic. Neurological symptoms have been reported among patients with coronavirus disease 2019 (COVID-19), but its effects on delirium remain unclear. This study aimed to compare the incidence of delirium between patients with COVID-19 and those without COVID-19, and to evaluate the impact of COVID-19 and frailty on delirium. Methods: This retrospective study included patients aged ≥ 20 years who were admitted to our intensive care unit (ICU) between January 2020 and February 2022. An inverse probability of treatment weighting using stabilized inverse propensity scores was adopted to minimize bias. After patient demographics were adjusted, the incidence of delirium, assessed using the Confusion Assessment Method for ICU, was compared between patients with COVID-19 and those without COVID-19. The effects of COVID-19 and the Clinical Frailty Scale score on delirium were analyzed by adjusting some covariates, including the sequential organ failure assessment (SOFA) score, using a generalized estimating equation. Results: Among 260 eligible patients, 226 patients were included. The weighted incidence of delirium was 56.9% and 61.9% in patients with and without COVID-19, respectively (p = 0.67). The generalized estimating equation revealed that the odds ratios (95% confidence interval) for COVID-19, the CFS score, and the SOFA score were 1.49 (0.62 -3.57), 1.46 (1.11 -1.91), and 1.22 (1.10 -1.36), respectively. Conclusion: CFS and SOFA scores on ICU admission may be associated with delirium, with no significant difference between patients with COVID-19 and those without COVID-19.

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Incidence and Risk Factors of Delirium in the Intensive Care Unit: A Prospective Cohort

Cited by 16 publications

References 46 publications

Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study

Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study

Early alteration of peripheral blood lymphocyte subsets as a risk factor for delirium in critically ill patients after cardiac surgery: A prospective observational study

Effects of Coronavirus Disease 2019 and Frailty on Delirium in the Intensive Care Unit: A Propensity Score Analysis

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