title: Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care Setting: An Observational Multicenter Study.
abstract: Aim. Delirium is common among mechanically ventilated patients in the intensive care unit (ICU). There are little data regarding delirium among mechanically ventilated patients in Africa. We sought to determine the burden of delirium and associated factors in Uganda. Methods. We conducted a multicenter prospective study among mechanically ventilated patients in Uganda. Eligible patients were screened daily for delirium using the confusional assessment method (CAM-ICU). Comparisons were made using t-test, chi-squares, and Fisher's exact test. Predictors were assessed using logistic regression. The level of statistical significance was set at P < 0.05. Results. Of 160 patients, 81 (51%) had delirium. Median time to onset of delirium was 3.7 days. At bivariate analysis, history of mental illness, sedation, multiorgan dysfunction, neurosurgery, tachypnea, low mean arterial pressure, oliguria, fevers, metabolic acidosis, respiratory acidosis, anaemia, physical restraints, marital status, and endotracheal tube use were significant predictors. At multivariable analysis, having a history of mental illness, sedation, respiratory acidosis, higher PEEP, endotracheal tubes, and anaemia predicted delirium. Conclusion. The prevalence of delirium in a young African population is lower than expected considering the high mortality. A history of mental illness, anaemia, sedation, endotracheal tube use, and respiratory acidosis were factors associated with delirium.
authors.affiliation: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Arthur
authors.identifier: 0000-0002-7025-0465
authors.initials: A
authors.lastname: Kwizera
authors.affiliation: Department of Internal Medicine, Mulago Hospital Complex, Mulago Hill, P.O. Box 7051, Kampala, Uganda.
authors.forename: Jane
authors.initials: J
authors.lastname: Nakibuuka
authors.affiliation: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Lameck
authors.initials: L
authors.lastname: Ssemogerere
authors.affiliation: Department of Internal Medicine, Mulago Hospital Complex, Mulago Hill, P.O. Box 7051, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Sendikadiwa
authors.affiliation: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Daniel
authors.initials: D
authors.lastname: Obua
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kizito
authors.affiliation: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Janat
authors.initials: J
authors.lastname: Tumukunde
authors.affiliation: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Agnes
authors.initials: A
authors.lastname: Wabule
authors.affiliation: Department of Psychiatry, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Noeline
authors.initials: N
authors.lastname: Nakasujja