Delirium in an intensive care unit: a study of risk factors.
OBJECTIVE
(1) To establish risk factors for the development of delirium in an intensive care unit (ICU) and (2) to determine the effect of delirium on morbidity, mortality and length of stay.


METHODS
Prospective study.


METHODS
Sixteen-bed medical/surgical ICU in a university hospital.


METHODS
Two hundred and sixteen consecutive patients admitted to the ICU for more than 24 h during 5 months were included in the study.


METHODS
Medical history, selected laboratory values, drugs received and factors that may influence patient psychological and emotional well-being were noted. All patients were screened with a delirium scale. A psychiatrist confirmed the diagnosis of delirium. Major complications such as self-extubation and removal of catheters, as well as mortality and length of stay were recorded.


RESULTS
Forty patients (19%) developed delirium; of these, one-third were not agitated. In the multivariate analysis hypertension, smoking history, abnormal bilirubin level, epidural use and morphine were statistically significantly associated with delirium. Traditional factors associated with the development of delirium on general ward patients were not significant in our study. Morbidity (self-extubation and removal of catheters), but not mortality, was clearly increased.


CONCLUSIONS
Predictive risk factors for the development of delirium in studies outside the ICU may not be applicable to critically ill patients. Delirium is associated with increased morbidity. Awareness of patients at risk may lead to better recognition and earlier intervention.
Dubois
M J
MJ
Division of Critical Care, Université de Montréal, Montréal, Canada.
Bergeron
N
N
Dumont
M
M
Dial
S
S
Skrobik
Y
Y
D000704:Analysis of Variance; D003693:Delirium / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors