Modifiable risk factors for delirium in critically ill trauma patients: a multicenter prospective study

Duceppe, Marc‐Alexandre; Elliott, Anila B.; Para, Marylou; Poirier, MC; Delisle, Marie-Soleil; Frenette, AJ; Deckelbaum, Dan; Razek, Tarek; Desjardins, Marie‐Pier; Jc, Bertrand; Bernard, Francis; Rico, Philippe; Burry, Lisa; Perreault, MM

doi:10.1186/cc14558

Cited by 6 publications

(13 citation statements)

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“…With these implications, it is not surprising that optimizing an ICU pain regimen is considered a protective modifiable risk factor for delirium development. 7 The 2013 ICU Pain, Agitation, and Delirium Clinical Practice Guidelines (ICU PAD guidelines) provide specific recommendations for optimal ICU pain management, which include the following: (1) performing pain assessments on all ICU patients every 2 hours and more often as needed using a validated pain assessment tool and (2) treating significant pain in patients in a timely fashion with appropriate medications. 25 If a patient is able to self-report their pain, then a numeric rating scale ranging from 0 to 10 should be used to quantify their degree of pain.…”

Section: Optimize Pain Managementmentioning

confidence: 99%

“…6 Advanced age, dementia, sensory impairment, diabetes mellitus, electrolyte derangement, history of cerebrovascular disease, and necessity for mechanical ventilation (MV) have been recognized as nonmodifiable risk factors for development of delirium. 6,7 While these factors are not modifiable, there are opportunities to aid in prevention of delirium in these populations. 7 Modifiable risk factors for delirium include pain control, reorientation, and mobilization as protective factors and use of benzodiazepines, physical restraints, or preclusion of mobility as factors with increased risk for delirium.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 While these factors are not modifiable, there are opportunities to aid in prevention of delirium in these populations. 7 Modifiable risk factors for delirium include pain control, reorientation, and mobilization as protective factors and use of benzodiazepines, physical restraints, or preclusion of mobility as factors with increased risk for delirium. 7,8 Although nonmodifiable risks for development of delirium exist in many ICU patients, there are still many management decisions clinicians may employ to minimize this risk.…”

Section: Introductionmentioning

confidence: 99%

“…7 Modifiable risk factors for delirium include pain control, reorientation, and mobilization as protective factors and use of benzodiazepines, physical restraints, or preclusion of mobility as factors with increased risk for delirium. 7,8 Although nonmodifiable risks for development of delirium exist in many ICU patients, there are still many management decisions clinicians may employ to minimize this risk. 7 Recent literature on ICU delirium focuses on pharmacologic risk factors and pharmacologic interventions to minimize severity and course of delirium.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 Although nonmodifiable risks for development of delirium exist in many ICU patients, there are still many management decisions clinicians may employ to minimize this risk. 7 Recent literature on ICU delirium focuses on pharmacologic risk factors and pharmacologic interventions to minimize severity and course of delirium. Commonly administered medications for ICU delirium include antipsychotics, sedativehypnotics, and opioids, although recent evidence indicates that these medications do not reliably treat or prevent delirium in these patients.…”

Section: Introductionmentioning

confidence: 99%

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Nonpharmacologic and Medication Minimization Strategies for the Prevention and Treatment of ICU Delirium: A Narrative Review

Blair

Mehmood

Rudnick

et al. 2018

J Intensive Care Med

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Delirium is a multifactorial entity, and its understanding continues to evolve. Delirium has been associated with increased morbidity, mortality, length of stay, and cost for hospitalized patients, especially for patients in the intensive care unit (ICU). Recent literature on delirium focuses on specific pharmacologic risk factors and pharmacologic interventions to minimize course and severity of delirium. While medication management clearly plays a role in delirium management, there are a variety of nonpharmacologic interventions, pharmacologic minimization strategies, and protocols that have been recently described. A PubMed search was performed to review the evidence for nonpharmacologic management, pharmacologic minimization strategies, and prevention of delirium for patients in the ICU. Recent approaches were condensed into 10 actionable steps to manage delirium and minimize medications for ICU patients and are presented in this review.

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Section: Optimize Pain Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nonpharmacologic and Medication Minimization Strategies for the Prevention and Treatment of ICU Delirium: A Narrative Review

Blair

Mehmood

Rudnick

et al. 2018

J Intensive Care Med

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Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

Williams

Estime

Kuza

2023

Current Opinion in Anaesthesiology

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Purpose of reviewThis article reviews the impact and importance of delirium on patients admitted to the ICU after trauma, including the latest work on prevention and treatment of this condition. As the population ages, the incidence of geriatric trauma will continue to increase with a concomitant rise in the patient and healthcare costs of delirium in this population.Recent findingsRecent studies have further defined the risk factors for delirium in the trauma ICU patient population, as well as better demonstrated the poor outcomes associated with the diagnosis of delirium in these patients. Recent trials and meta-analysis offer some new evidence for the use of dexmedetomidine and quetiapine as preferred agents for prevention and treatment of delirium and add music interventions as a promising part of nonpharmacologic bundles.SummaryTrauma patients requiring admission to the ICU are at significant risk of developing delirium, an acute neuropsychiatric disorder associated with increased healthcare costs and worse outcomes including increased mortality. Ideal methods for prevention and treatment of delirium are not well established, especially in this population, but recent research helps to clarify optimal prevention and treatment strategies.

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Development of a Delirium Risk Predication Model among ICU Patients in Oman

Al-Hoodar

Lazarus

Omari

et al. 2022

Anesthesiology Research and Practice

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Background. Delirium is a common disorder among patients admitted to intensive care units. Identification of the predicators of delirium is very important to improve the patient’s quality of life. Methods. This study was conducted in a prospective observational design to build a predictive model for delirium among ICU patients in Oman. A sample of 153 adult ICU patients from two main hospitals participated in the study. The Intensive Care Delirium Screening Checklist (ICDSC) was used to assess the participants for delirium twice daily. Result. The results showed that the incidence of delirium was 26.1%. Multiple logistic regression analysis showed that sepsis (odds ratio (OR) = 9.77; 95% confidence interval (CI) = 1.91–49.92; P < 0.006 ), metabolic acidosis (odds ratio (OR) = 3.45; 95% confidence interval [CI] = 1.18–10.09; P = 0.024 ), nasogastric tube use (odds ratio (OR) 9.74; 95% confidence interval (CI) = 3.48–27.30; P ≤ 0.001 ), and APACHEII score (OR = 1.22; 95% CI = 1.09–1.37; P ≤ 0.001 ) were predictors of delirium among ICU patients in Oman (R2=0.519, adjusted R2=0.519, P ≤ 0.001 ). Conclusion. To prevent delirium in Omani hospitals, it is necessary to work on correcting those predictors and identifying other factors that had effects on delirium development. Designing of a prediction model may help on early delirium detection and implementation of preventative measures.

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Modifiable risk factors for delirium in critically ill trauma patients: a multicenter prospective study

Cited by 6 publications

References 0 publications

Nonpharmacologic and Medication Minimization Strategies for the Prevention and Treatment of ICU Delirium: A Narrative Review

Nonpharmacologic and Medication Minimization Strategies for the Prevention and Treatment of ICU Delirium: A Narrative Review

Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management

Development of a Delirium Risk Predication Model among ICU Patients in Oman

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