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2022, Number 4

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Med Crit 2022; 36 (4)

Delirium prevalence, risk factors and outcome in the Intensive Care Unit at Hospital Ángeles del Carmen

Corona MJC, Iñiguez PH, Medina RE
Full text How to cite this article 10.35366/105792

DOI

DOI: 10.35366/105792
URL: https://dx.doi.org/10.35366/105792

Language: Spanish
References: 22
Page: 215-222
PDF size: 270.34 Kb.


Key words:

Delirium, Intensive Care Unit, prevalence, risk, treatment.

ABSTRACT

Introduction: Delirium is a common condition in critical care patients, and is associated with multiple risk factors, poor prognosis and high mortality rate. Material and methods: An observational analytic study was conducted in a the Intensive Care Unit during 2017-2018, documenting delirium prevalence, risk factors and their association with mortality, pharmacological and non-pharmacological treatment, using IBM© SPSS© Statistics V24. Results: 563 patients were included, finding a prevalence of 14% (n = 79). The most significant risk factors were preexisting dementia (OR 9.0), sedation (OR 6.7), alcohol abuse (OR 5.0), non-invasive mechanical ventilation (OR 2.8) and age > 67 years (OR 2.7). The general mortality rate was 10.1% (13.9% in patients with delirium, 10.3% in hyperactive/mixed delirium and 23.8% in hypoactive delirium, OR 1.93, CI 95% 0.88-4.19, p = 0.12). Absence of non-pharmacological treatment was associated with higher mortality (30.8 vs 10.6%, OR 2.74, CI 95% 1.02-7.39, p = 0.05). Conclusion: There is a low prevalence of delirium in our unit, with differences in delirium types and risk factors. Hypoactive delirium and absence of non-pharmacological treatment were associated with higher mortality.


REFERENCES

  1. Hshieh TT, Inouye SK, Oh ES. Delirium in the elderly. Clin Geriatr Med. 2020;36(2):183-199. doi: 10.1016/j.cger.2019.11.001.

  2. Marcantonio ER. Delirium in hospitalized older adults. N Engl J Med. 2017;377(15):1456-1466. doi: 10.1056/NEJMcp1605501.

  3. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911-922. doi: 10.1016/S0140-6736(13)60688-1.

  4. Villalpando-Berumen JM, Pineda-Colorado AM, Palacios P, Reyes-Guerrero J, Villa AR, Gutiérrez-Robledo LM. Incidence of delirium, risk factors, and long-term survival of elderly patients hospitalized in a medical specialty teaching hospital in Mexico City. Int Psychogeriatr. 2003;15(4):325-336. doi: 10.1017/s104161020300958x.

  5. Ramirez-Bermudez J, Lopez-Gomez M, Sosa AL, Aceves S, Nader-Kawachi J, Nicolini H. Frequency of delirium in a neurological emergency room. J Neuropsychiatry Clin Neurosci. 2006;18:108-112.

  6. Addesi D, Maio R, Smirne N, et al. Prevalence of delirium in a population of elderly outpatients with dementia: a retrospective study. JAD. 2017;61(1):1-7. doi: 10.3233/JAD-170339.

  7. Mattar I, Chan MF, Childs C. Risk factors for acute delirium in critically ill adult patients: a systematic review. ISRN Critical Care. 2013;2013:1-10. doi: 10.5402/2013/910125.

  8. Torres-Pérez J, Jiménez-Gómez JC, Vázquez-García A, et al. Prevalencia de delirium en adultos mayores con fractura de cadera. Med Univer. 2010;12(49):203-208.

  9. Salluh JI, Soares M, Teles JM, et al. Delirium epidemiology in critical care (DECCA): an international study. Crit Care. 2010;14(6):R210.

  10. Ahmed S, Leurent B, Sampson EL. Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis. Age Ageing. 2014;43(3):326-33. doi: 10.1093/ageing/afu022.

  11. Silva-Reyna P, Lopez-Bascopé A. Factores asociados a delirium postoperatorio en adultos mayores sometidos a anestesia general en el Hospital Ángeles Metropolitano. Rev Mex Anest. 2019;42(2):83-88.

  12. Van Rompaey B, Elseviers MM, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Bossaert L. Risk factors for delirium in intensive care patients: a prospective cohort study. Crit Care. 2009;13(3):R77. doi: 10.1186/cc7892.

  13. Van Rompaey B, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Bossaert L. Risk factors for intensive care delirium: a systematic review. Intensive Crit Care Nurs. 2008;24(2):98-107. doi: 10.1016/j.iccn.2007.08.005.

  14. Devlin JW, Skrobik Y, Gélinas C, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825-e873. doi: 10.1097/CCM.0000000000003299.

  15. Carrillo-Esper R, Sosa-García JO. Delirium en el enfermo grave. Med Int Mex. 2010;26(2):130-139.

  16. Girard TD, Thompson JL, Pandharipande PP, et al. Clinical phenotypes of delirium during critical illness and severity of subsequent long-term cognitive impairment: a prospective cohort study. Lancet Respir Med. 2018;6(3):213-222. doi: 10.1016/S2213-2600(18)30062-6.

  17. Krewulak KD, Stelfox HT, Leigh JP, Ely EW, Fiest KM. Incidence and prevalence of delirium subtypes in an adult ICU: a systematic review and meta-analysis. Crit Care Med. 2018;46(12):2029-2035. doi: 10.1097/CCM.0000000000003402.

  18. Tobar E, Romero C, Galleguillos T, et al. Método para la evaluación de la confusión en la unidad de cuidados intensivos para el diagnóstico de delirium: adaptación cultural y validación de la versión en idioma español. Med Intensiva. 2010;34:4-13.

  19. Burry L, Hutton B, Williamson DR, et al. Pharmacological interventions for the treatment of delirium in critically ill adults. Cochrane Database Syst Rev. 2019;9(9):CD011749. doi: 10.1002/14651858.CD011749.pub2.

  20. Oh ES, Fong TG, Hshieh TT, Inouye SK. Delirium in older persons: advances in diagnosis and treatment. JAMA. 2017;318(12):1161-1174. doi: 10.1001/jama.2017.12067.

  21. Herling SF, Greve IE, Vasilevskis EE, et al. Interventions for preventing intensive care unit delirium in adults. Cochrane Database Syst Rev. 2018;11(11):CD009783. doi: 10.1002/14651858.CD009783.pub2.

  22. Maldonado JR. Acute brain failure: pathophysiology, diagnosis, management, and sequelae of delirium. Crit Care Clin. 2017;33(3):461-519. doi: 10.1016/j.ccc.2017.03.013.




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Med Crit. 2022;36