title: Frequency, severity, and treatment of agitation in young versus elderly patients in the ICU.
abstract: OBJECTIVE
  To study the frequency, duration, severity, and treatment of agitation in patients in the intensive care unit (ICU) to determine if the elderly represent a distinct population.
  
  
  METHODS
  Prospective cohort study
  
  
  METHODS
  Tertiary care, 10-bed, multidisciplinary ICU.
  
  
  METHODS
  All patients older than 18 years of age admitted for longer than 24 hours during a 4-month period.
  
  
  METHODS
  None.
  
  
  RESULTS
  One hundred thirty patients were studied for 916 patient-days; 63 (48%) were elderly (> 65 yrs). Nurses and physicians described agitated behavior in 92 patients (70.8%) during 534 (58.3%) patient-days, and it was severe or dangerous in 60 patients (46.1%) during 273 (30%) patient-days. There were no age-related differences in frequency, severity, and duration of agitation. Opiates, benzodiazepines, and haloperidol were administered during 72%, 62%, and 29% of agitated patient-days, respectively. Haloperidol was administered more often to elderly patients (p=0.015); otherwise no between-group differences were noted. Daily dosing requirements were less in the elderly for intermittent intravenous lorazepam, haloperidol, and morphine but not for midazolam (p=0.15). When these dosages were corrected for body mass, no statistical differences between young and old were found.
  
  
  CONCLUSIONS
  In the ICU, the elderly are not a distinct population for agitation.
authors.affiliation: University of Vermont College of Medicine, Burlington, USA.
authors.forename: G L
authors.initials: GL
authors.lastname: Fraser
authors.forename: B S
authors.initials: BS
authors.lastname: Prato
authors.forename: R R
authors.initials: RR
authors.lastname: Riker
authors.forename: D
authors.initials: D
authors.lastname: Berthiaume
authors.forename: M L
authors.initials: ML
authors.lastname: Wilkins
mesh_terms: D018806:APACHE; D000328:Adult; D000367:Age Factors; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008140:Lorazepam / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000188:drug therapy*; D014149:Tranquilizing Agents / Q000008:administration & dosage*
chemical_list: D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D014150:Antipsychotic Agents; D014149:Tranquilizing Agents; D009020:Morphine; D006220:Haloperidol; D008140:Lorazepam