title: Severity of delirium in the ICU is associated with short term cognitive impairment. A prospective cohort study.
abstract: OBJECTIVE
  To examine the hypothesis that severity of delirium in the intensive care unit (ICU) is positively associated with cognitive impairment at the time of hospital discharge.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Adult medical and surgical ICU of a tertiary-care teaching hospital in Japan in ICU patients who were enrolled and admitted for more than 48hours.
  
  
  METHODS
  Severity of delirium was represented as a score of the Intensive Care Delirium Screening Checklist (ICDSC) during the patients' stay in the ICU under the assumption that higher ICDSC score indicated severe delirium. After discharge from the ICU, the patients were followed up for cognitive impairment using the Mini-Mental State Examination (MMSE).
  
  
  RESULTS
  Of the 79 patients enrolled, 50 (63.3%) developed delirium during their stay in the ICU. Patients who developed delirium had higher rates of cognitive impairment (28.0% vs. 3.4%, p=0.03). After adjusting for covariates, the averaged ICDSC score during the ICU stay indicated a positive association between severity of delirium and cognitive impairment at the time of hospital discharge (adjusted odds ratio (OR) 1.6; 95% confidential interval (CI), 1.02-2.54; p=0.041).
  
  
  CONCLUSIONS
  Our findings indicate that severity of delirium during ICU stay may be associated with cognitive impairment at the time of discharge from the hospital in ICU survivors.
authors.affiliation: Intensive Care Unit, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan(1). Electronic address: gongehead@yahoo.co.jp.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Sakuramoto
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Jesmin
authors.initials: J
authors.lastname: Subrina
authors.affiliation: Intensive Care Unit, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan(1).
authors.forename: Takeshi
authors.initials: T
authors.lastname: Unoki
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Mizutani
authors.affiliation: Faculty of Nursing and Medical Care, Keio University, 35 Shinano-machi, Shinjuku-ku, Tokyo, Japan(1).
authors.forename: Hiroko
authors.initials: H
authors.lastname: Komatsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist; D060825:Cognitive Dysfunction / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003422:Critical Care; D003693:Delirium / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers
keywords: Cognitive impairment; Critical illness; Delirium; Intensive Care Delirium Screening Checklists