title: Delirium in postoperative nonventilated intensive care patients: risk factors and outcomes.
abstract: BACKGROUND
  Delirium features can vary greatly depending on the postoperative population studied; however, most studies focus only on high-risk patients. Describing the impact of delirium and risk factors in mixed populations can help in the development of preventive actions.
  
  
  METHODS
  The occurrence of delirium was evaluated prospectively in 465 consecutive nonventilated postoperative patients admitted to a surgical intensive care unit (SICU) using the confusion assessment method (CAM). Patients with and without delirium were compared. A multiple logistic regression was performed to identify the main risk factors for delirium in the first 24 h of admission to the SICU and the main predictors of outcomes.
  
  
  RESULTS
  Delirium was diagnosed in 43 (9.2%) individuals and was more frequent on the second and third days of admission. The presence of delirium resulted in longer lengths of SICU and hospital stays [6 days (3-13) vs. 2 days (1-3), p < 0.001 and 26 days (12-39) vs. 6 days (3-13), p <0.001, respectively], as well as higher hospital and SICU mortality rates [16.3% vs. 4.0%, p = 0.004 and 6.5% vs. 1.7%, p = 0.042, respectively]. The risk factors for delirium were age (odds ratio (OR), 1.04 [1.02-1.07]), Acute Physiologic Score (APS; OR, 1.11 [1.04-1.2]), emergency surgery (OR, 8.05 [3.58-18.06]), the use of benzodiazepines (OR, 2.28 [1.04-5.00]), and trauma (OR, 6.16 [4.1-6.5]).
  
  
  CONCLUSIONS
  Delirium negatively impacts postoperative nonventilated patients. Risk factors can be used to detect high-risk patients in a mixed population of SICU patients.
authors.affiliation: Ventilatory Care Unit, Copa D'Or Hospital, Rio de Janeiro, Brazil. rodrigobserafim@gmail.com.
authors.forename: Rodrigo Bernardo
authors.initials: RB
authors.lastname: Serafim
authors.forename: Maximiliano F
authors.initials: MF
authors.lastname: Dutra
authors.forename: Felipe
authors.initials: F
authors.lastname: Saddy
authors.forename: Bernardo
authors.initials: B
authors.lastname: Tura
authors.forename: Jose Eduardo Couto
authors.initials: JE
authors.lastname: de Castro
authors.forename: Luciana C
authors.initials: LC
authors.lastname: Villarinho
authors.forename: Maria
authors.initials: M
authors.lastname: da Gloria Santos
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Bozza
authors.forename: José Rodolfo
authors.initials: JR
authors.lastname: Rocco