title: The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients.
abstract: OBJECTIVE
  Previously, delirium has been identified as an independent risk factor for mortality in critically ill medical patients. We undertook this study to examine the relationships among medication usage, delirium, and clinical outcomes in a critically ill surgical/trauma population.
  
  
  METHODS
  Prospective, multicentered, observational study.
  
  
  METHODS
  Two surgical intensive care units in level 1 trauma centers.
  
  
  METHODS
  One hundred thirty-four consecutive surgical adult patients requiring mechanical ventilation (MV) for greater than 24 hours.
  
  
  METHODS
  Daily delirium assessment with the Confusion Assessment Method-Intensive Care Unit tool, outcomes assessment, and prospective data collection.
  
  
  RESULTS
  Of the 134 patients who met inclusion criteria, 84 patients (63%) developed delirium at some point during their intensive care unit (ICU) stay. Delirium was associated with more MV days (9.1 vs. 4.9 days, p < 0.01), longer ICU stay (12.2 vs. 7.4 days, p < 0.01), longer hospital stay (20.6 vs. 14.7 days, p < 0.01). Additionally, greater cumulative lorazepam dose (p = 0.012), and higher cumulative fentanyl dose (p = 0.035) were administered in the delirium group.
  
  
  CONCLUSIONS
  Delirium in the surgical/trauma ICU cohort is independently associated with more days requiring MV, longer ICU length of stay, and longer hospital length of stay. Additionally, greater amounts of lorazepam and fentanyl were administered to patients with delirium.
authors.affiliation: University of Chicago Hospitals, Chicago, IL, USA. ishaq.lat@uchospitals.edu
authors.forename: Ishaq
authors.initials: I
authors.lastname: Lat
authors.forename: Wes
authors.initials: W
authors.lastname: McMillian
authors.forename: Scott
authors.initials: S
authors.lastname: Taylor
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Janzen
authors.forename: Stella
authors.initials: S
authors.lastname: Papadopoulos
authors.forename: Laura
authors.initials: L
authors.lastname: Korth
authors.forename: As'ad
authors.initials: A
authors.lastname: Ehtisham
authors.forename: Joe
authors.initials: J
authors.lastname: Nold
authors.forename: Suresh
authors.initials: S
authors.lastname: Agarwal
authors.forename: Ruben
authors.initials: R
authors.lastname: Azocar
authors.forename: Peter
authors.initials: P
authors.lastname: Burke
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012307:Risk Factors; D014947:Wounds and Injuries / Q000150:complications*