Ryy Wan1, C A McKenzie2, D Taylor3, L Camporota4, M Ostermann4. 1. Department of Pharmacy, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK. Electronic address: Ruth.Wan@gstt.nhs.uk. 2. Institute of Pharmaceutical Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, UK; Department of Pharmacy, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK. 3. Institute of Pharmaceutical Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, UK; Department of Pharmacy, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, UK. 4. King's College London, Department of Critical Care, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK.
Abstract
PURPOSE: Delirium and acute kidney injury (AKI) are common organ dysfunctions during critical illness. Both conditions are associated with serious short- and long-term complications. We investigated whether AKI is a risk factor for hyperactive delirium. METHODS: This was a single-centre case control study conducted in a 30 bedded mixed Intensive Care Unit in the UK. Hyperactive delirium cases were identified by antipsychotic initiation and confirmation of delirium diagnosis through validated chart review. Cases were compared with non-delirium controls matched by Acute Physiology and Chronic Health Evaluation II score and gender. AKI was defined by the KDIGO criteria. RESULTS: 142 cases and 142 matched controls were identified. AKI stage 3 was independently associated with hyperactive delirium [Odds ratio (OR) 5.40 (95% confidence interval (CI) 2.33-12.51]. Other independent risk factors were mechanical ventilation [OR 2.70 (95% CI 1.40-5.21)], alcohol use disorder [OR 5.80 (95% CI 1.90-17.72)], and dementia [OR 9.76 (95% CI 1.09-87.56)]. Hospital length of stay was significantly longer in delirium cases (29 versus 20 days; p = .004) but hospital mortality was not different. CONCLUSIONS: AKI stage 3 is independently associated with hyperactive delirium. Further research is required to explore the factors that contribute to this association. Crown
PURPOSE:Delirium and acute kidney injury (AKI) are common organ dysfunctions during critical illness. Both conditions are associated with serious short- and long-term complications. We investigated whether AKI is a risk factor for hyperactive delirium. METHODS: This was a single-centre case control study conducted in a 30 bedded mixed Intensive Care Unit in the UK. Hyperactive delirium cases were identified by antipsychotic initiation and confirmation of delirium diagnosis through validated chart review. Cases were compared with non-delirium controls matched by Acute Physiology and Chronic Health Evaluation II score and gender. AKI was defined by the KDIGO criteria. RESULTS: 142 cases and 142 matched controls were identified. AKI stage 3 was independently associated with hyperactive delirium [Odds ratio (OR) 5.40 (95% confidence interval (CI) 2.33-12.51]. Other independent risk factors were mechanical ventilation [OR 2.70 (95% CI 1.40-5.21)], alcohol use disorder [OR 5.80 (95% CI 1.90-17.72)], and dementia [OR 9.76 (95% CI 1.09-87.56)]. Hospital length of stay was significantly longer in delirium cases (29 versus 20 days; p = .004) but hospital mortality was not different. CONCLUSIONS:AKI stage 3 is independently associated with hyperactive delirium. Further research is required to explore the factors that contribute to this association. Crown
Authors: Giovanni Ostuzzi; Chiara Gastaldon; Davide Papola; Andrea Fagiolini; Serdar Dursun; David Taylor; Christoph U Correll; Corrado Barbui Journal: Ther Adv Psychopharmacol Date: 2020-07-20