Subsyndromal delirium in the ICU: evidence for a disease spectrum
| Autor: | Sébastien, Ouimet, Richard, Riker, Nicolas, Bergeron, Nicolas, Bergeon, Mariève, Cossette, Brian, Kavanagh, Yoanna, Skrobik |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Critical Care and Intensive Care Medicine behavioral disciplines and activities Severity of Illness Index Organic mental disorders Intensive care Anesthesiology mental disorders Severity of illness Outcome Assessment Health Care medicine Humans Hospital Mortality Intensive care medicine Aged Medical Audit Evidence-Based Medicine business.industry Disease spectrum Quebec Delirium Evidence-based medicine Length of Stay Middle Aged medicine.disease Checklist nervous system diseases Intensive Care Units Female medicine.symptom business |
| Zdroj: | Intensive Care Medicine. 33:1677-1677 |
| ISSN: | 1432-1238 0342-4642 |
| DOI: | 10.1007/s00134-007-0731-y |
| Popis: | ICU delirium is common and adverse. The Intensive Care Delirium Screening Checklist (ICDSC) score ranges from 0 to 8, with a score of 4 or higher indicating clinical delirium. We investigated whether lower (subsyndromal) values affect outcome.600 patients were evaluated with the ICDSC every 8[Symbol: see text]h.Of 558 assessed patients 537 noncomatose patients were divided into three groups: no delirium (score = 0; n = 169, 31.5%), subsyndromal delirium (score = 1-3; n = 179, 33.3%), and clinical delirium (scoreor=4; n = 189, 35.2%). ICU mortality rates were 2.4%, 10.6%, and 15.9% in these three groups, respectively. Post-ICU mortality was significantly greater in the clinical delirium vs. no delirium groups (hazard ratio = 1.67) after adjusting for age, APACHE II score, and medication-induced coma. Relative ICU length of stay was: no deliriumsubsyndromal deliriumclinical delirium and hospital LOS: no deliriumsubsyndromal delirium approximately clinical delirium. Patients with no delirium were more likely to be discharged home and less likely to need convalescence or long-term care than those with subsyndromal delirium or clinical delirium. ICDSC score increments higher than 4/8 were not associated with a change in mortality or LOS.Clinical delirium is common, important and adverse in the critically ill. A graded diagnostic scale permits detection of a category of subsyndromal delirium which occurs in many ICU patients, and which is associated with adverse outcome. |
| Databáze: | OpenAIRE |
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