title: Delirium in Survivors of Cardiac Arrest Treated With Mild Therapeutic Hypothermia.
abstract: Mild therapeutic hypothermia is recommended for comatose patients resuscitated from cardiac arrest. However, the prevalence of delirium and its associated risk factors have not been assessed in survivors of cardiac arrest treated with therapeutic hypothermia.
  
  
  
  To determine the prevalence of and risk factors for delirium among survivors of cardiac arrest who were treated with therapeutic hypothermia.
  
  
  
  A retrospective observational study of patients treated with therapeutic hypothermia after cardiac arrest from 2007 through 2014. Baseline demographic data and daily delirium assessments throughout the intensive care unit stay were obtained. The association between duration of delirium and various risk factors was assessed.
  
  
  
  Of 251 patients, 107 (43%) awoke from coma. Among the 107 survivors, all had at least 1 day of delirium during their intensive care unit stay. Median number of days of delirium was 4.0 (interquartile range, 2.0-7.5). Multivariable analysis revealed that age (odds ratio, 1.72; 95% CI, 1.0-2.95; P = .05), time from cardiopulmonary resuscitation to return of spontaneous circulation (odds ratio 1.52; 95% CI, 1.11-2.07; P = .01), and total dose of prewarming propofol (odds ratio, 0.02; 95% CI, 0.00-0.48; P = .02) were associated with duration of delirium.
  
  
  
  All survivors of cardiac arrest treated with mild therapeutic hypothermia had at least 1 day of delirium. Age and time from initiation of cardiopulmonary resuscitation to return of spontaneous circulation were associated with prolonged delirium, whereas exposure to propofol was protective against delirium. These findings are limited to this unique cohort and may not be generalizable to different populations.
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center. jpollock@medicine.umaryland.edu.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Pollock
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Hollenbeck
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Holmes
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Young
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: Matthew
authors.initials: M
authors.lastname: Peters
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: E Wesley
authors.initials: EW
authors.lastname: Ely
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: John A
authors.initials: JA
authors.lastname: McPherson
authors.affiliation: Jeremy S. Pollock and Matthew Peters are fellows, Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland. Ryan D. Hollenbeck is an interventionalist, Division of Cardiology, Mercy Medical Center, Cedar Rapids, Iowa. Li Wang is a statistician, Division of Biostatistics, Benjamin Holmes and Michael N. Young are fellows, Department of Cardiology, and John A. McPherson is a professor, Department of Internal Medicine, Vanderbilt University, Nashville, Tennessee. Wesley Ely is a professor, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, and the Veterans Affairs Tennessee, and associate director of aging research, Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville, Tennessee. Eduard E. Vasilevskis is an assistant professor, Division of General Internal Medicine and Public Health, Section of Hospital Medicine, Vanderbilt University, and the Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center.
authors.forename: Eduard E
authors.initials: EE
authors.lastname: Vasilevskis
mesh_terms: D015984:Causality; D015331:Cohort Studies; D003128:Coma / Q000453:epidemiology; D015897:Comorbidity; D003422:Critical Care / Q000379:methods; D003693:Delirium / Q000453:epidemiology*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data*