Abstract
Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period. We evaluated the incidence of delirium and its predisposing and precipitating risk factors. All patients were assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU). Of the total of 332 patients with a median APACHE II (the Acute Physiology and Chronic Health Evaluation) score of 12, who were evaluated for delirium, 48 could not be assessed using CAM-ICU (47 due to prolonged coma, 1 due to language barriers). The incidence of delirium was 26.1%, with trauma and medical patients being more likely to develop delirium than surgical patients. Risk of delirium was significantly associated with age ≥ 65 years, and alcohol abuse in their anamnesis, with APACHE II score on admission, and with the use of sedatives and/or vasopressors. Delirious patients who remained in the ICU for a prolonged period showed a greater need for ventilator support and had a greater ICU-mortality.
Highlights
Delirium is a common complication in critically ill patients that is characterized by a sudden onset of impaired consciousness and changes in cognitive function
Total samples of 332 patients were screened for delirium and associated risk factors
The incidence of delirium in the mixed group admitted to a six-bed Intensive Care Unit (ICU) during the given period of one year was 26.1%
Summary
Delirium is a common complication in critically ill patients that is characterized by a sudden onset of impaired consciousness (reduced clarity of awareness of the environment, inability to sustain or shift attention) and changes in cognitive function (disorientation, memory impairment, etc.). It usually develops over a short period of time and fluctuates during the day. In critically ill patients many factors can affect the prognosis such as hypoxemia, infection, systemic inflammation, or metabolic imbalance and all can lead to organ dysfunction. Delirious patients who remained in the ICU for a prolonged period showed a greater need for ventilator support and had a greater ICU-mortality
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