The Incidence and Prognosis of ICU Delirium: A Retrospective Study from a Single Center
- https://doi.org/10.2991/icres.k.210206.001How to use a DOI?
- Delirium; ICU; sleep quality; 28-day mortality; length of ICU stay
Purpose: Delirium is a frequent occurrence amongst Intensive Care Unit (ICU) patients, but studies on its causes are sparse and its risk factors vary from disease to disease. Here, in this study, an attempt was made to investigate the factors associated with the prognosis of delirium in the ICU.
Methods: An observed study was performed of consecutive patients from September 2016 to November 2016 who were admitted to the ICU. The patients were screened for delirium by using the diagnostic tools of the Richmond Agitation Sedation Scale score and the Confusion Assessment Method ICU. Patients were divided into subgroups according to heart/vascular, cerebral, pulmonary, maxillofacial/limbs, obstetric, urinary and spinal disease.
Results: A total of 406 patients of which 186 developed delirium (45.8%). The main causes of delirium were different. The only independent factor for delirium in heart and vascular subgroups was the quality of sleep (Odds Ratio (OR) = 0.236, p < 0.001 [0.111–0.500]). For those with intestinal disease, the risk factors included age (OR = 2.514, p = 0.002 [1.397–4.524]), use of vasoactive therapies (OR = 13.799, p = 0.002 [2.669–71.361]) and the quality of sleep (OR = 0.114, p < 0.001 [0.036–0.366]). Older age (OR = 1.100, p = 0.022 [1.014–1.194]), higher acute physiology, age and chronic health evaluation II scales (OR = 1.255, p < 0.001 [1.112–1.417]) and the quality of sleep (OR = 0.090, p = 0.034 [0.010–0.829]) were noted as risk factors for septic shock patients. Delirium led to extended ICU-stays (p < 0.001), and only the subgroups of septic shock patients showed a difference in 28-day mortality rates (p = 0.006).
Conclusion: The incidence of delirium and its associated risk factors varied according to disease type. In the study cohort, the highest 28-day mortality was recorded for the patients admitted for septic shock who had developed delirium.
- Chinese Abstract
结果：共纳入了406例患者，其中186例为谵妄患者（45.8%）。造成谵妄的主要原因各异；在心脏/血管疾病亚组中，睡眠质量是导致谵妄的唯一的独立危险因素（OR=0.236；95%置信区间，[0.111–0.500]；p < 0.001）。在胃肠道疾病患者中，导致谵妄的危险因素包括年龄（OR=2.514；95%置信区间，[1.397–4.524]；p = 0.002)、使用血管活性药物（OR = 13.799；95%置信区间，[2.669–71.361]； p = 0.002）和睡眠质量（OR = 0.114；95%置信区间，[0.036–0.366]；p < 0.001）。此外，年龄较大（OR = 1.100；95%置信区间， [1.014–1.194]； p = 0.022），较高的急性生理学、年龄和慢性健康评估II 评分（OR =1.255；95%置信区间，[1.112–1.417]； p < 0.001）和睡眠质量（OR = 0.090；95%置信区间，[0.010–0.829]； p = 0.034）被认为是脓毒性休克患者的危险因素。谵妄导致ICU住院时间延长（p < 0.001），且与其他亚组相比，脓毒性休克亚组的28天病死率存在差异（p = 0.006）。
- © 2021 First Affiliated Hospital of Zhengzhou University. Publishing services by Atlantis Press International B.V.
- Open Access
- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
Cite this article
TY - JOUR AU - Qing Feng AU - Yuhang Ai AU - Meilin Ai AU - Li Huang AU - Qianyi Peng AU - Lina Zhang PY - 2021 DA - 2021/02/13 TI - The Incidence and Prognosis of ICU Delirium: A Retrospective Study from a Single Center JO - Intensive Care Research SP - 16 EP - 23 VL - 1 IS - 1-2 SN - 2666-9862 UR - https://doi.org/10.2991/icres.k.210206.001 DO - https://doi.org/10.2991/icres.k.210206.001 ID - Feng2021 ER -