title: Delirium in critically ill patients: impact on long-term health-related quality of life and cognitive functioning.
abstract: OBJECTIVE
  To examine the impact of delirium during intensive care unit stay on long-term health-related quality of life and cognitive function in intensive care unit survivors.
  
  
  METHODS
  Prospective 18-month follow-up study.
  
  
  METHODS
  Four intensive care units of a university hospital.
  
  
  METHODS
  A median of 18 months after intensive care discharge, questionnaires were sent to 1,292 intensive care survivors with (n = 272) and without (n = 1020) delirium during their intensive care stay.
  
  
  RESULTS
  The Short Form-36v1, checklist individual strength-fatigue, and cognitive failure questionnaire were used. Covariance analysis was performed to adjust for relevant covariates. Of the 915 responders, 171 patients were delirious during their intensive care stay (median age 65 [interquartile range 58-85], Acute Physiology and Chronic Health Evaluation II score 17 [interquartile range 14-20]), and 745 patients were not (median age 65 [interquartile range 57-72], Acute Physiology and Chronic Health Evaluation II score 13 [interquartile range 10-16]). After adjusting for covariates, no differences were found between delirium and nondelirium survivors on the Short Form-36 and checklist individual strength-fatigue. However, survivors who had suffered from delirium reported that they made significantly more social blunders, and their total cognitive failure questionnaire score was significantly higher, compared to survivors who had not been delirious. Survivors of a hypoactive delirium subtype performed significantly better on the domain mental health than mixed and hyperactive delirium patients. Duration of delirium was significantly correlated to problems with memory and names.
  
  
  CONCLUSIONS
  Intensive care survivors with delirium during their intensive care unit stay had a similar adjusted health-related quality of life evaluation, but significantly more cognitive problems than those who did not suffer from delirium, even after adjusting for relevant covariates. In addition, the duration of delirium was related to long-term cognitive problems.
authors.affiliation: Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, The Netherlands. m.vandenboogaard@ic.umcn.nl
authors.forename: Mark
authors.initials: M
authors.lastname: van den Boogaard
authors.forename: Lisette
authors.initials: L
authors.lastname: Schoonhoven
authors.forename: Andrea W M
authors.initials: AW
authors.lastname: Evers
authors.forename: Johannes G
authors.initials: JG
authors.lastname: van der Hoeven
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
authors.forename: Peter
authors.initials: P
authors.lastname: Pickkers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D016638:Critical Illness / Q000523:psychology*; D003693:Delirium / Q000150:complications / Q000523:psychology*; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*