Farshid Rahimi-Bashar1, Ghazal Abolhasani1, Nahid Manouchehrian2, Nasrin Jiryaee3, Amir Vahedian-Azimi4, Amirhossein Sahebkar5,6,7,8. 1. Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. 2. Department of Anesthesiology, Fatemi Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran. 3. Department of Community Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. 4. Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. 5. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. 6. Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 7. Halal Research Center of IRI, FDA, Tehran, Iran. 8. School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
PURPOSE: The purpose of this study was to determine the incidence, risk factors, and impact of delirium on outcomes in ICU patients. In addition, the scoring systems were measured consecutively to characterize how these scores changed with time in patients with and without delirium. Material and Methods. A prospective cohort study enrolling 400 consecutive patients admitted to the ICU between 2018 and 2019 due to trauma or surgery. Patients were followed up for the development of delirium over ICU days using the Confusion Assessment Method (CAM) for the ICU and Intensive Care Delirium Screening Checklist (ICDSC). Cox model logistic regression analysis was used to explore delirium risk factors. RESULTS: Delirium occurred in 108 (27%) patients during their ICU stay, and the median onset of delirium was 4 (IQR 3-4) days after admission. According to multivariate cox regression, the expected hazard for delirium was 1.523 times higher in patients who used mechanical ventilator as compared to those who did not (HR: 1.523, 95% CI: 1.197-2.388, P < 0.001). CONCLUSION: Our findings suggest that an important opportunity for improving the care of critically ill patients may be the determination of modifiable risk factors for delirium in the ICU. In addition, the scoring systems (APACHE IV, SOFA, and RASS) are useful for the prediction of delirium in critically ill patients.
PURPOSE: The purpose of this study was to determine the incidence, risk factors, and impact of delirium on outcomes in ICU patients. In addition, the scoring systems were measured consecutively to characterize how these scores changed with time in patients with and without delirium. Material and Methods. A prospective cohort study enrolling 400 consecutive patients admitted to the ICU between 2018 and 2019 due to trauma or surgery. Patients were followed up for the development of delirium over ICU days using the Confusion Assessment Method (CAM) for the ICU and Intensive Care Delirium Screening Checklist (ICDSC). Cox model logistic regression analysis was used to explore delirium risk factors. RESULTS: Delirium occurred in 108 (27%) patients during their ICU stay, and the median onset of delirium was 4 (IQR 3-4) days after admission. According to multivariate cox regression, the expected hazard for delirium was 1.523 times higher in patients who used mechanical ventilator as compared to those who did not (HR: 1.523, 95% CI: 1.197-2.388, P < 0.001). CONCLUSION: Our findings suggest that an important opportunity for improving the care of critically ill patients may be the determination of modifiable risk factors for delirium in the ICU. In addition, the scoring systems (APACHE IV, SOFA, and RASS) are useful for the prediction of delirium in critically ill patients.
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