The Incidence and Prognosis of ICU Delirium: A Retrospective Study from a Single Center

DOI

10.2991/icres.k.210206.001How to use a DOI?

Keywords

Delirium; ICU; sleep quality; 28-day mortality; length of ICU stay

Abstract

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

目的：谵妄是重症监护病房（ICU）患者的常见症状，但对其病因的研究很少，且其危险因素因疾病而异。在本次研究中，我们探讨了与ICU患者谵妄预后相关的因素。

方法：连续纳入2016年9月至2016年11月入住ICU的患者进行观察性研究。采用Richmond躁动-镇静评分量表和ICU意识状态评估法评估患者谵妄情况；并根据心脏/血管、脑、肺、颌面部/四肢、产科、泌尿和脊柱疾病将其分为亚组。

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）。

结论：谵妄的发生率及其相关的危险因素因疾病而异。在本研究队列中，发生谵妄的脓毒性休克患者28天病死率最高。

Copyright

© 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/).

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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  - 10.2991/icres.k.210206.001
ID  - Feng2021
ER  -