The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients.
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.
Lat
Ishaq
I
University of Chicago Hospitals, Chicago, IL, USA. ishaq.lat@uchospitals.edu
McMillian
Wes
W
Taylor
Scott
S
Janzen
Jeff M
JM
Papadopoulos
Stella
S
Korth
Laura
L
Ehtisham
As'ad
A
Nold
Joe
J
Agarwal
Suresh
S
Azocar
Ruben
R
Burke
Peter
P
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*