Risk factors for delirium after major trauma.
BACKGROUND
This study aimed to describe the natural history of delirium after major injury, to identify risk factors that predict the development of postinjury delirium, and to compare outcome measures in subjects with and without delirium.


METHODS
A prospective study was performed on patients with an injury severity score of 8 or higher admitted to the trauma intensive care unit (ICU) of a level I trauma center. Patients underwent daily assessments for delirium with the Confusion Assessment Method-ICU.


RESULTS
Sixty-nine patients (53 male) were enrolled. Delirium occurred in 41 (59%) subjects. Logistic regression found lower arrival Glasgow Coma Score (12 +/- 1.0 vs 15 +/- .1; P < .01), increased blood transfusions (2.8 +/- .7 vs .5 +/- .3; P < .01), and higher multiple organ failure score (1.2 +/- .2 vs .1 +/- .1; P < .01) to be the strongest predictors for developing delirium. Outcome measures revealed subjects with delirium had longer hospital stays, longer ICU stays, and were more likely require postdischarge institutionalization.


CONCLUSIONS
Delirium is common in the trauma ICU. Higher multiple organ failure score was the strongest predictor of postinjury delirium.
Angles
Erik M
EM
Department of Surgery, University of Colorado at Denver, Health Sciences Center, 12631 East 17th Ave., Mail Stop C313, PO Box 6511, Aurora, CO, USA.
Robinson
Thomas N
TN
Biffl
Walter L
WL
Johnson
Jeff
J
Moss
Marc
M
Tran
Zung V
ZV
Moore
Ernest E
EE
D000328:Adult; D003120:Colorado / Q000453:epidemiology; D003693:Delirium / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014505:Urban Population; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis