Severity of delirium in the ICU is associated with short term cognitive impairment. A prospective cohort study

Sakuramoto, Hideaki; Jesmin, Subrina; Unoki, Takeshi; Mizutani, Taro; Komatsu, Hiroko

doi:10.1016/j.iccn.2015.01.001

Cited by 26 publications

(21 citation statements)

References 41 publications

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“…19 Whilst improvements in cognitive function typically occur in the first year post ICU discharge, 20 between a quarter and half of ICU survivors report persistent impairment at one, 3,4 two, 21 and six years. 22 Both longer duration of delirium 4,5 and, more recently, greater severity of delirium, 23 have been identified as risk factors of cognitive impairment. Analgesics and sedative medications have also been posited as possible mechanisms through which both delirium and cognitive impairment develops, 19 although findings to date remain mixed.…”

Section: Introductionmentioning

confidence: 99%

Long-term cognitive impairment and delirium in intensive care: A prospective cohort study

Mitchell

Shum

Mihala

et al. 2018

Australian Critical Care

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Section: Introductionmentioning

confidence: 99%

Long-term cognitive impairment and delirium in intensive care: A prospective cohort study

Mitchell

Shum

Mihala

et al. 2018

Australian Critical Care

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“…The association between delirium and cognitive impairment is more consistently demonstrated. Several multicenter prospective studies ( 5 , 8 , 10 , 17 ) and a meta-analysis ( 1 ) confirmed this association. In our study, most patients with delirium had severe cognitive impairment at the time of hospital discharge.…”

Section: Discussionmentioning

confidence: 72%

“…Patients were classified as having normal cognition (score 3 24), mild cognitive impairment (score between 19 and 23), or severe cognitive impairment (score between 0 and 18). ( 17 )…”

Section: Methodsmentioning

confidence: 99%

Delirium and quality of life in critically ill patients: a prospective cohort study

Luz

Santos

Ramos

et al. 2020

Revista Brasileira De Terapia Intensiva

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Objective To evaluate the association between the incidence of delirium in the intensive care unit and quality of life 1 month after hospital discharge. Methods This was a prospective cohort study conducted in the intensive care units of two medium-complexity hospitals from December 2015 to December 2016. Delirium was identified using the Confusion Assessment Method for the Intensive Care Unit scale. At the time of hospital discharge, functional capacity and cognition were assessed with the Barthel index and the Mini Mental State Examination, respectively. Thirty days after patient discharge, the World Health Organization Quality of Life-BREF questionnaire was administered by telephone. Results A total of 216 patients were included. Delirium was identified in 127 (58.8%) of them. Patients with delirium exhibited greater functional dependence (median Barthel index 50.0 [21.2 - 70.0] versus 80.0 [60.0 - 95.0]; p < 0.001) and lower cognition (Mini Mental State Examination score 12.9 ± 7.5 versus 20.7 ± 9.8; p < 0.001) at hospital discharge. There was no difference in any of the quality-of-life domains evaluated 1 month after hospital discharge between patients with and without delirium . Conclusion Our findings suggest that patients with delirium in the intensive care unit do not have worse quality of life 1 month after hospital discharge, despite presenting greater cognitive impairment and functional disability at the time of hospital discharge.

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“…There was inconclusive evidence for the association of delirium severity with cognitive ability ( Table 4 ); two studies reported a negative association between delirium severity and cognitive function (multivariable [ 20 , 21 ]), and one study reported no significant associations (multivariable [ 26 ]). Results were similar when stratified into ICU and non-ICU populations.…”

Section: Resultsmentioning

confidence: 99%

The association of delirium severity with patient and health system outcomes in hospitalised patients: a systematic review

et al. 2020

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Abstract Background delirium is an acute state of confusion that affects >20% of hospitalised patients. Recent literature indicates that more severe delirium may lead to worse patient outcomes and health system outcomes, such as increased mortality, cognitive impairment and length of stay (LOS). Methods using systematic review methodology, we summarised associations between delirium severity and patient or health system outcomes in hospitalised adults. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and Scopus databases with no restrictions, from inception to 25 October 2018. We included original observational research conducted in hospitalised adults that reported on associations between delirium severity and patient or health system outcomes. Quality of included articles was assessed using the Newcastle–Ottawa Scale. The level of evidence was quantified based on the consistency of findings and quality of studies reporting on each outcome. Results we included 20 articles evaluating associations that reported: mortality (n = 11), cognitive ability (n = 3), functional ability (n = 3), patient distress (n = 1), quality of life (n = 1), hospital LOS (n = 4), intensive care unit (ICU) LOS (n = 2) and discharge home (n = 2). There was strong-level evidence that delirium severity was associated with increased ICU LOS and a lower proportion of patients discharged home. There was inconclusive evidence for associations between delirium severity and mortality, hospital LOS, functional ability, cognitive ability, patient distress and quality of life. Conclusion delirium severity is associated with increased ICU LOS and a lower proportion of patients discharged home. Delirium severity may be a useful adjunct to existing delirium screening to determine the burden to health care system resources.

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Severity of delirium in the ICU is associated with short term cognitive impairment. A prospective cohort study

Cited by 26 publications

References 41 publications

Long-term cognitive impairment and delirium in intensive care: A prospective cohort study

Long-term cognitive impairment and delirium in intensive care: A prospective cohort study

Delirium and quality of life in critically ill patients: a prospective cohort study

The association of delirium severity with patient and health system outcomes in hospitalised patients: a systematic review

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