Tomonori Yamamoto1, Yasumitsu Mizobata2, Yu Kawazoe3, Kyohei Miyamoto4, Yoshinori Ohta5, Takeshi Morimoto6, Hitoshi Yamamura7. 1. Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan. Electronic address: m1162149@med.osaka-cu.ac.jp. 2. Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan. 3. Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. 4. Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan. 5. Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. 6. Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan. 7. Osaka Prefectural Nakakawachi Emergency and Critical Care Center, Osaka, Japan.
Abstract
PURPOSE: This study aimed to investigate incidence, risk factors, and outcomes for sepsis-associated delirium (SAD) in mechanically ventilated patients. MATERIALS AND METHODS: We performed a retrospective post-hoc analysis of the DExmedetomidine for Sepsis in Intensive care unit Randomized Evaluation (DESIRE) trial. Outcomes included 28-day mortality, ventilator-free days, length of ICU stay, self-extubation, and re-intubation. Multivariable analysis was performed to identify variables independently associated with SAD. RESULTS: We retrospectively divided the patients into two groups: delirium group (n = 89) and non-delirium group (n = 98). There were no significant differences between the groups in 28-day mortality, self-extubation, and re-intubation. The number of ventilator-free days was significantly less in the delirium vs. non-delirium group (17 vs. 22 days, p = .006), and the length of ICU stay was significantly longer in the delirium group (10 vs. 5 days, p = .04). Multivariable analyses revealed that emergency surgery, more doses of midazolam, and fentanyl were independent predictors for SAD. CONCLUSIONS:SAD was associated with a less number of ventilator-free days and longer length of ICU stay. Emergency surgery, more doses of midazolam, and fentanyl may be independent risk factors for SAD in mechanically ventilated patients with sepsis.
RCT Entities:
PURPOSE: This study aimed to investigate incidence, risk factors, and outcomes for sepsis-associated delirium (SAD) in mechanically ventilated patients. MATERIALS AND METHODS: We performed a retrospective post-hoc analysis of the DExmedetomidine for Sepsis in Intensive care unit Randomized Evaluation (DESIRE) trial. Outcomes included 28-day mortality, ventilator-free days, length of ICU stay, self-extubation, and re-intubation. Multivariable analysis was performed to identify variables independently associated with SAD. RESULTS: We retrospectively divided the patients into two groups: delirium group (n = 89) and non-delirium group (n = 98). There were no significant differences between the groups in 28-day mortality, self-extubation, and re-intubation. The number of ventilator-free days was significantly less in the delirium vs. non-delirium group (17 vs. 22 days, p = .006), and the length of ICU stay was significantly longer in the delirium group (10 vs. 5 days, p = .04). Multivariable analyses revealed that emergency surgery, more doses of midazolam, and fentanyl were independent predictors for SAD. CONCLUSIONS:SAD was associated with a less number of ventilator-free days and longer length of ICU stay. Emergency surgery, more doses of midazolam, and fentanyl may be independent risk factors for SAD in mechanically ventilated patients with sepsis.