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Risk factors associated with the development of delirium in general ICU patients. A prospective observational study

Beatriz Lobo-Valbuena, F. Gordo Vidal, A. Abella, Sofía García-Manzanedo, María-Mercedes Garcia-Arias, I. Torrejón, David Varillas‐Delgado, Rosario Molina

2021PLoS ONE30 citationsDOIOpen Access PDF

Abstract

OBJECTIVE: We aimed to analyze risk factors related to the development of delirium, aiming for early intervention in patients with greater risk. MATERIAL AND METHODS: Observational study, including prospectively collected patients treated in a single general ICU. These were classified into two groups, according to whether they developed delirium or not (screening performed using CAM-ICU tool). Demographics and clinical data were analyzed. Multivariate logistic regression analyses were performed to quantify existing associations. RESULTS: 1462 patients were included. 93 developed delirium (incidence: 6.3%). These were older, scored higher on the Clinical Frailty Scale, on the risk scores on admission (SAPS-3 and SOFA), and had a greater number of organ failures (OF). We observed more incidence of delirium in patients who (a) presented more than two OF (20.4%; OR 4.9; CI95%: 2.9-8.2), and (b) were more than 74 years old albeit having <2 OF (8.6%; OR 2.1; CI95%: 1.3-3.5). Patients who developed delirium had longer ICU and hospital length-of-stays and a higher rate of readmission. CONCLUSIONS: The highest risk observed for developing delirium clustered in patients who presented more than 2 OF and patients over 74 years old. The detection of patients at high risk for developing delirium could imply a change in management and improved quality of care.

Topics & Concepts

DeliriumObservational studyMedicineIncidence (geometry)Logistic regressionProspective cohort studyEmergency medicineIntensive care medicineMultivariate analysisInternal medicineOpticsPhysicsIntensive Care Unit Cognitive DisordersSepsis Diagnosis and TreatmentNosocomial Infections in ICU
Risk factors associated with the development of delirium in general ICU patients. A prospective observational study | Litcius