Karla D Krewulak1, Henry T Stelfox2, E Wesley Ely3, Kirsten M Fiest4. 1. Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 2. Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Alberta Health Services, Calgary, AB, Canada; O'Brien Institute for Public Health, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada. 3. Tennessee Valley Veteran's Affairs Geriatric Research Education Clinical Center (VA GRECC), Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States. 4. Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Alberta Health Services, Calgary, AB, Canada; O'Brien Institute for Public Health, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada; Department of Psychiatry, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada. Electronic address: kmfiest@ucalgary.ca.
Abstract
PURPOSE: Use systematic review methodology to summarize risk factors and outcomes for each delirium subtype (hypoactive, hyperactive and mixed) in an adult ICU population. MATERIALS AND METHODS: We searched the MEDLINE, Embase, CINAHL, SCOPUS, Web of Science and PsycINFO databases from database inception until August 13, 2018, with no restrictions. RESULTS: Of 9635 abstracts, 20 studies were included. Older age was not associated with any delirium subtype in 4/7 (57%) studies. Sex was not associated with any delirium subtype in 4/4 (100%) studies. Mortality was consistently associated with hypoactive delirium in 4/7 (57%) studies. The evidence supporting the association of APACHE-II score, mechanical ventilation, length of stay, duration of delirium and removal of tubes were inconsistent across studies. CONCLUSIONS: Although included studies reported on many subtype-specific risk factors and outcomes, heterogeneity in reporting and methodological quality limited the generalizability of the results and the evidence for many subtype-specific risk factors or outcomes is inconsistent across studies. Standardized methodology and the creation of a universal template for collecting data in ICU delirium studies are essential moving forward; helping to identify subtype-specific risk factors or outcomes and strengthen the association of potential risk factors or outcomes.
PURPOSE: Use systematic review methodology to summarize risk factors and outcomes for each delirium subtype (hypoactive, hyperactive and mixed) in an adult ICU population. MATERIALS AND METHODS: We searched the MEDLINE, Embase, CINAHL, SCOPUS, Web of Science and PsycINFO databases from database inception until August 13, 2018, with no restrictions. RESULTS: Of 9635 abstracts, 20 studies were included. Older age was not associated with any delirium subtype in 4/7 (57%) studies. Sex was not associated with any delirium subtype in 4/4 (100%) studies. Mortality was consistently associated with hypoactive delirium in 4/7 (57%) studies. The evidence supporting the association of APACHE-II score, mechanical ventilation, length of stay, duration of delirium and removal of tubes were inconsistent across studies. CONCLUSIONS: Although included studies reported on many subtype-specific risk factors and outcomes, heterogeneity in reporting and methodological quality limited the generalizability of the results and the evidence for many subtype-specific risk factors or outcomes is inconsistent across studies. Standardized methodology and the creation of a universal template for collecting data in ICU delirium studies are essential moving forward; helping to identify subtype-specific risk factors or outcomes and strengthen the association of potential risk factors or outcomes.
Authors: Heidi Lindroth; Babar A Khan; Janet S Carpenter; Sujuan Gao; Anthony J Perkins; Sikandar H Khan; Sophia Wang; Richard N Jones; Malaz A Boustani Journal: Ann Am Thorac Soc Date: 2020-09
Authors: Monika Sadlonova; Jonathan Vogelgsang; Claudia Lange; Irina Günther; Adriana Wiesent; Charlotte Eberhard; Julia Ehrentraut; Mareike Kirsch; Niels Hansen; Hermann Esselmann; Charles Timäus; Thomas Asendorf; Benedict Breitling; Mohammed Chebbok; Stephanie Heinemann; Christopher Celano; Ingo Kutschka; Jens Wiltfang; Hassina Baraki; Christine A F von Arnim Journal: BMC Cardiovasc Disord Date: 2022-06-30 Impact factor: 2.174
Authors: Claudia Dziegielewski; Charlenn Skead; Toros Canturk; Colleen Webber; Shannon M Fernando; Laura H Thompson; Madison Foster; Vanja Ristovic; Peter G Lawlor; Dipayan Chaudhuri; Chintan Dave; Brent Herritt; Shirley H Bush; Salmaan Kanji; Peter Tanuseputro; Kednapa Thavorn; Erin Rosenberg; Kwadwo Kyeremanteng Journal: Crit Care Res Pract Date: 2021-04-24
Authors: Kirstine N la Cour; Nina C Andersen-Ranberg; Sarah Weihe; Lone M Poulsen; Camilla B Mortensen; Cilia K W Kjer; Marie O Collet; Stine Estrup; Ole Mathiesen Journal: Crit Care Date: 2022-03-03 Impact factor: 9.097