Risk Factors of Delirium among Patients Admitted in Critical Care Unit

Abstract

Delirium is a common problem in intensive care unit (ICU) patients. The present study was conducted to identify the risk factors of delirium among patients admitted in critical care unit. The research design used was prospective descriptive design. The sample constituted 124 patients who were admitted in intensive care units and were selected using a consecutive sampling technique. The results showed that 17.7 percent of critically ill patients developed delirium. Out of this, 31.8 percent of patients developed severe delirium and 68.2 percent had mild-moderate delirium. Most of the patients developed delirium on the second or third day of ICU stay. The predisposing factors of delirium were current alcoholism (OR=5.211, CI=0.977-27.787, p=0.034), comorbidities such as seizures (OR=5.211, CI=0.977- 27.787, p=0.034), and chronic kidney disease (OR=2.857, CI=1.038-7.866, p=0.037). The precipitating factors of delirium were severe pain (OR=29.400; CI=7.970-108.452), sleep disturbance (OR=20.563, CI=6.646-63.618), restraints (OR=19.603, CI=6.237-61.616), benzodiazepines (OR=15.947, CI=1.574-161.568), movement restriction due to tubes and catheters (OR=10.100, CI=0.873-116.799), invasive mechanical ventilation (OR=9.927, CI=3.485-28.277, antiarrhythmics (OR= 9.706, CI=2.121-44.423), head injury (OR=5.857, CI=3.968-8.646), alkalosis (OR=5.444, CI=1.247-23.779), acidosis (OR=4.727, CI=1.621- 13.789), hypoxemia (OR=4.200, CI=1.596-11.051), hypercapnia (OR=4.167, CI=1.552- 11.187), hypernatremia (OR=3.461, CI=1.174-10.200), vasopressors (OR=3.450, CI=1.100- 10.819), corticosteroids (OR=2.884, CI=1.045-7.963), length of ICU stay (OR=0.068, CI=0.023-0.199). Nurses have an important role in the early identification and prevention of delirium by regular assessment of delirium and implementing appropriate strategies.