Incidence of delirium in the critical care unit and risk factors in the Central Region, Saudi Arabia

Abazid, Rami M.; Alharbi, Shaima A.; Allihimy, Abdulaziz S.; Aldrewesh, Dawood A.; Alkuraydis, Sarah A.; Alhammad, Ibtihal M.; Elbashir, Ahmed Y.; Widyan, Adel M.; Abohamr, Samah I.

doi:10.15537/smj.2021.42.4.20200754

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…The patients in our study were 49.1±17.3 years old on average, whereas mean age was 55±18 years in a study conducted by Abazid et al in 2021. 17 In our study, 66.7% patients were male which was similar to finding of Lobo et al ( 2021), who reported that male were 62.3% in total sample. 18 Our study found that the incidence of delirium was 33.3% after admission.…”

Section: Discussionsupporting

confidence: 91%

Incidence and risk factors of delirium in the intensive care unit of SIUT Karachi.

Nazia Arain,

Fakhir Raza Haidri,

Bushra Zafar

et al. 2024

TPMJ

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Objective: To estimate the incidence and risk factors of delirium in intensive care unit (ICU) of Sindh Institute of Urology and Transplantation (SIUT), Karachi. Study Design: Cross-sectional study. Setting: The ICU of SIUT, Karachi, Pakistan. Period: February 2023 to August, 2023. Methods: Patients over 18 years of age who were admitted to the ICU for more than 24 hours were analyzed. Patient with Richmond agitation sedation score (RASS >-2) were assessed for delirium using the confusion assessment method (CAM)-ICU method. Delirium subtypes were also evaluated. Domographic and clinical risk factors were evaluated for possible relationship with the existence of delirium. Results: Total 96 patient were enrolled in the study, 64 (66.7%) were male and 32 (33.3%) female. The mean age was 49.1±17.3 years. Mean RASS and CAM-ICU scores were 0.53±1.31 and 1.0±1.42 respectively. Delirium was present in 32 (33.3%) patients. It was noted that 45.4% patients had hypoactive delirium, 31.8% hyperactive delirium, and 22.7% mixed type. Patients aged 50 years or above had higher odds of delirium (OR: 0.41 [0.17-0.98], p=0.045), On multivariable regression model, BMI <25 Kg/m2, coexistence of ischemic heart disease and chronic kidney disease, patients with septic shock, post-operative patients, need of sedation were significantly associated with higher odds of delirium. Conclusion: Delirium is a frequent condition in ICU patients, with a higher occurrence of hypoactive delirium. The leading risk factors associated with delirium were older age, ischemic heart disease, chronic kidney disease and use of sedative drugs.

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Section: Discussionsupporting

confidence: 91%

Incidence and risk factors of delirium in the intensive care unit of SIUT Karachi.

Nazia Arain,

Fakhir Raza Haidri,

Bushra Zafar

et al. 2024

TPMJ

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“…Regarding hypoalbuminemia, the relationship between malnutrition and delirium incidence and related outcomes is well documented. [22][23][24][25][26][27] However, while preoperative hypoalbuminemia as a measure of malnutrition is associated with postoperative delirium incidence, 20,[28][29][30][31] we could not locate evidence indicating that preoperative hypoalbuminemia predicts the disposition of postoperative patients who experience delirium.…”

Section: Discussionmentioning

confidence: 73%

Impact of nursing interventions on discharge disposition in patients with postoperative delirium

Zhao,

Quon,

Luke

et al. 2023

Nursing

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Purpose: To identify patient characteristics and perioperative factors associated with non-home patient discharges and the impact of current delirium nursing interventions on discharge disposition, especially non-home dispositions. Methods: A retrospective pilot chart review was conducted using electronic health records from five networked hospitals in the Mountain West region of the US. The sample comprised 75 randomly selected patients aged 65 or older who screened positive for delirium during hospitalization. Relationships between patient characteristics, nursing interventions, and discharge dispositions were analyzed using chi-square tests and logistic regression. Results: Most participants (69.3%) were discharged to non-home facilities. Delayed urinary catheter removal was a significant nursing intervention factor. Patients with delayed urinary catheter removal were at increased risk of being discharged to a non-home setting compared with those with early urinary catheter removal (aOR: 14.11, P = .010). Preoperative hypoalbuminemia and surgery durations exceeding 60 minutes were associated with non-home dispositions. Conclusion: Delayed urinary catheter removal, surgery duration greater than 1 hour, and preoperative hypoalbuminemia increased the likelihood of non-home discharge placement for older adults who experience postoperative delirium.

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“…Research and literature reviews have demonstrated patients in critical care units (CCUs) are at increased risk of delirium (Abazid et al., 2021; Ramos et al., 2023). Delirium is characterized by disturbance of consciousness and accompanying changes in condition.…”

mentioning

confidence: 99%

Bringing Delirium to Light

Savino,

Vergara,

Ramos

et al. 2024

Professional Case Management

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Background: Delirium is a serious complication in patients in the critical care unit (CCU) that may lead to prolonged hospitalization if left undetected. The CCU at our hospital does not have a framework for determining delirium that could affect patient outcomes and discharge planning. Primary Practice Setting: CCU in a community hospital. Method: A posttest-only design was used for this study. We established a framework for the early assessment of delirium, educated and trained nurses to detect delirium, collaborated with the informatics department, intensivist, nursing, respiratory therapy and worked with case management to deploy the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). We used a one-tailed independent t test to determine the impact of CAM-ICU on length of stay (LOS). Cross-tabulation and chi-square tests were used to examine the impact of CAM-ICU tool on home care utilization between the intervention and comparison groups. Results: There was a 3.12% reduction in LOS after implementing the CAM-ICU tool. Also, a reduction in home care service utilization demonstrated statistical significance (p= .001) between the intervention group (62.5%; n= 177) and the comparison group (37.5%; n= 106). Implications for Case Management Practice: Case managers are essential in improving care transitions. Case managers need to become competent in understanding the implications of the CAM-ICU tool because of their relevant role in the multidisciplinary rounds as advocates to improve care transitions across the continuum of care. Case managers need to have an understanding on how to escalate when changes in the Richmond Agitation-Sedation Scale scores occur during the multidisciplinary rounds because it can affect care coordination throughout the hospital. Conclusions: Implementing the CAM-ICU decreased LOS, and reduced health care utilization. The early identification of patients with delirium can affect the outcomes of critically ill patients and entails multidisciplinary collaboration.

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Incidence of delirium in the critical care unit and risk factors in the Central Region, Saudi Arabia

Cited by 5 publications

References 13 publications

Incidence and risk factors of delirium in the intensive care unit of SIUT Karachi.

Incidence and risk factors of delirium in the intensive care unit of SIUT Karachi.

Impact of nursing interventions on discharge disposition in patients with postoperative delirium

Bringing Delirium to Light

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