TY - JOUR
T1 - Factors associated with a persistent delirium in the intensive care unit
T2 - A retrospective cohort study
AU - Kooken, Rens W J
AU - van den Berg, Maarten
AU - Slooter, Arjen J C
AU - Pop-Purceleanu, Monica
AU - van den Boogaard, Mark
N1 - Funding Information:
The authors would like to thank prof. Devlin (Northeastern University Boston) and dr. Neufeld (Johns Hopkins Baltimore) for their input in the delirium expert meeting. The authors would also like to thank Sanne Schröduer, Sjef van der Velde and Ruud van Kaam for their help with data extraction from electronic patient records by developing an electronic database.
Publisher Copyright:
© 2021 The Authors
PY - 2021/12
Y1 - 2021/12
N2 - PURPOSE: To explore differences between ICU patients with persistent delirium (PD), non-persistent delirium (NPD) and no delirium (ND), and to determine factors associated with PD.MATERIALS AND METHODS: Retrospective cohort study including all ICU adults admitted for ≥12 h (January 2015-February 2020), assessable for delirium and followed during their entire hospitalization. PD was defined as ≥14 days of delirium. Factors associated with PD were determined using multivariable logistic regression analysis.RESULTS: Out of 10,295 patients, 3138 (30.5%) had delirium, and 284 (2.8%) had PD. As compared to NPD (n = 2854, 27.7%) and ND (n = 7157, 69.5%), PD patients were older, sicker, more physically restrained, longer comatose and mechanically ventilated, had a longer ICU and hospital stay, more ICU readmissions and a higher mortality rate. Factors associated with PD were age (adjusted odds ratio [aOR] 1.03; 95% confidence interval [CI] 1.02-1.04); emergency surgical (aOR 1.84; 95%CI 1.26-2.68) and medical (aOR 1.57; 95%CI 1.12-2.21) referral, mean Sequential Organ Failure Assessment (SOFA) score before delirium onset (aOR 1.18; 95%CI 1.13-1.24) and use of physical restraints (aOR 5.02; 95%CI 3.09-8.15).CONCLUSIONS: Patients with persistent delirium differ in several characteristics and had worse short-term outcomes. Physical restraints were the most strongly associated with PD.
AB - PURPOSE: To explore differences between ICU patients with persistent delirium (PD), non-persistent delirium (NPD) and no delirium (ND), and to determine factors associated with PD.MATERIALS AND METHODS: Retrospective cohort study including all ICU adults admitted for ≥12 h (January 2015-February 2020), assessable for delirium and followed during their entire hospitalization. PD was defined as ≥14 days of delirium. Factors associated with PD were determined using multivariable logistic regression analysis.RESULTS: Out of 10,295 patients, 3138 (30.5%) had delirium, and 284 (2.8%) had PD. As compared to NPD (n = 2854, 27.7%) and ND (n = 7157, 69.5%), PD patients were older, sicker, more physically restrained, longer comatose and mechanically ventilated, had a longer ICU and hospital stay, more ICU readmissions and a higher mortality rate. Factors associated with PD were age (adjusted odds ratio [aOR] 1.03; 95% confidence interval [CI] 1.02-1.04); emergency surgical (aOR 1.84; 95%CI 1.26-2.68) and medical (aOR 1.57; 95%CI 1.12-2.21) referral, mean Sequential Organ Failure Assessment (SOFA) score before delirium onset (aOR 1.18; 95%CI 1.13-1.24) and use of physical restraints (aOR 5.02; 95%CI 3.09-8.15).CONCLUSIONS: Patients with persistent delirium differ in several characteristics and had worse short-term outcomes. Physical restraints were the most strongly associated with PD.
KW - Acute encephalopathy
KW - Critical care
KW - Delirium
KW - ICU
KW - Intensive care units
KW - Outcomes
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85115107869&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2021.09.001
DO - 10.1016/j.jcrc.2021.09.001
M3 - Article
C2 - 34547553
SN - 0883-9441
VL - 66
SP - 132
EP - 137
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -