title: Predictors of agitation in critically ill adults.
abstract: BACKGROUND
  Agitation in critically ill adults is a frequent complication of hospitalization and results in multiple adverse outcomes. Potential causes of agitation are numerous; however, data on factors predictive of agitation are limited.
  
  
  OBJECTIVE
  To identify predictors of agitation by examining demographic and clinical characteristics of critically ill patients.
  
  
  METHODS
  A medical record review was performed. Documentation of agitation was indicated by scores on the Richmond Agitation-Sedation Scale or the use of an agitation keyword. Records of 200 patients from 1 medical and 1 surgical intensive care unit were used for the study. Risk factors were determined for 2 points in time: admission to the intensive care unit and within 24 hours before the first episode of agitation. Data on baseline demographics, preadmission risk factors, and clinical data were collected and were evaluated by using logistic multivariable regression to determine predictors of agitation.
  
  
  RESULTS
  Predictors of agitation on admission to intensive care were history of use of illicit substances, height, respiratory and central nervous system subscores on the Sequential Organ Failure Assessment, and use of restraints. Predictors of agitation within 24 hours before the onset of agitation were history of psychiatric diagnosis, height, score on the Sequential Organ Failure Assessment, ratio of Pao2 to fraction of inspired oxygen less than 200, serum pH, percentage of hours with restraints, percentage of hours of mechanical ventilation, pain, and presence of genitourinary catheters.
  
  
  CONCLUSIONS
  Predictors of agitation on admission and within 24 hours before the onset of agitation were primarily clinical variables.
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center in Houston. Mary Jo Grap is the Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is an associate dean, Research and Innovation, and a professor, University of South Florida College of Nursing, Tampa, Florida. Christine M. Schubert is an associate professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio. burkrv@gmail.com.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Burk
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center in Houston. Mary Jo Grap is the Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is an associate dean, Research and Innovation, and a professor, University of South Florida College of Nursing, Tampa, Florida. Christine M. Schubert is an associate professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Grap
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center in Houston. Mary Jo Grap is the Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is an associate dean, Research and Innovation, and a professor, University of South Florida College of Nursing, Tampa, Florida. Christine M. Schubert is an associate professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Munro
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center in Houston. Mary Jo Grap is the Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is an associate dean, Research and Innovation, and a professor, University of South Florida College of Nursing, Tampa, Florida. Christine M. Schubert is an associate professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Schubert
authors.affiliation: Ruth S. Burk is an assistant professor, Department of Acute and Continuing Care, University of Texas Health Science Center in Houston. Mary Jo Grap is the Nursing Alumni Distinguished Professor, Adult Health and Nursing Systems Department, School of Nursing, and Curtis N. Sessler is the Orhan Muren Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Cindy L. Munro is an associate dean, Research and Innovation, and a professor, University of South Florida College of Nursing, Tampa, Florida. Christine M. Schubert is an associate professor, Department of Mathematics and Statistics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Dayton, Ohio.
authors.forename: Curtis N
authors.initials: CN
authors.lastname: Sessler
mesh_terms: D000328:Adult; D000368:Aged; D000378:Agonistic Behavior; D003422:Critical Care; D016638:Critical Illness / Q000523:psychology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011237:Predictive Value of Tests; D011595:Psychomotor Agitation / Q000175:diagnosis* / Q000209:etiology*; D012121:Respiration, Artificial; D012124:Respiratory Care Units; D012149:Restraint, Physical; D012307:Risk Factors; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000150:complications; D014193:Trauma Centers; D014546:Urinary Catheterization
chemical_list: D010100:Oxygen