Incidence, Subtypes, Risk factors, and Outcome of Delirium: A Prospective Observational Study from Indian Intensive Care Unit.

Autor: Tiwari AM; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Zirpe KG; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Khan AZ; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Gurav SK; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Deshmukh AM; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Suryawanshi PB; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Kapse US; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Wankhede PP; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Bamne SN; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Bhoyar AP; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Malhotra RV; Department of Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India., Sontakke SM; Department of Neurology, Ruby Hall Clinic, Pune, Maharashtra, India., Borade PB; Department of Psychiatry, Ruby Hall Clinic, Pune, Maharashtra, India.
Jazyk: angličtina
Zdroj: Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine [Indian J Crit Care Med] 2023 Feb; Vol. 27 (2), pp. 111-118.
DOI: 10.5005/jp-journals-10071-24407
Abstrakt: Background: Delirium is a common, under-recognized, and often fatal condition in critically ill patients, characterized by acute disorder of attention and cognition. The global prevalence varies with a negative impact on outcomes. A paucity of Indian studies exists that have systematically assessed delirium.
Objective: A prospective observational study designed to determine the incidence, subtypes, risk factors, complications, and outcome of delirium in Indian intensive care units (ICUs).
Patients and Methods: Among 1198 adult patients screened during the study period (December 2019-September 2021), 936 patients were included. The confusion assessment method score (CAM-ICU) and Richmond agitation sedation scale (RASS) were used, with additional confirmation of delirium by the psychiatrist/neurophysician. Risk factors and related complications were compared with a control group.
Results: Delirium occurred in 22.11% of critically ill patients. The hypoactive subtype was the most common (44.9%). The risk factors recognized were higher age, increased acute physiology and chronic health evaluation (APACHE-II) score, hyperuricemia, raised creatinine, hypoalbuminemia, hyperbilirubinemia, alcoholism, and smoking. Precipitating factors included patients admitted on noncubicle beds, proximity to the nursing station, requiring ventilation, as well as the use of sedatives, steroids, anticonvulsants, and vasopressors. Complications observed in the delirium group were unintentional removal of catheters (35.7%), aspiration (19.8%), need for reintubation (10.6%), decubitus ulcer formation (18.4%), and high mortality (21.3% vs 5%).
Conclusion: Delirium is common in Indian ICUs with a potential effect on length of stay and mortality. Identification of incidence, subtype, and risk factors is the first step toward prevention of this important cognitive dysfunction in the ICU.
How to Cite This Article: Tiwari AM, Zirpe KG, Khan AZ, Gurav SK, Deshmukh AM, Suryawanshi PB, et al . Incidence, Subtypes, Risk factors, and Outcome of Delirium: A Prospective Observational Study from Indian Intensive Care Unit. Indian J Crit Care Med 2023;27(2):111-118.
Competing Interests: Source of support: Nil Conflict of interest: Dr Kapil Gangadhar Zirpe is associated as the Editorial Board member of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of this editorial board member and his research group.
(Copyright © 2023; The Author(s).)
Databáze: MEDLINE
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