title: Risk factors for agitation in critically ill patients.
abstract: To evaluate the incidence of agitation in the first 7 days after intensive care unit admission, its risk factors and its associations with clinical outcomes.
  This single-center prospective cohort study included all patients older than 18 years with a predicted stay > 48 hours within the first 24 hours of intensive care unit admission. Agitation was defined as a Richmond Agitation Sedation Scale score ≥ +2, an episode of agitation or the use of a specific medication recorded in patient charts.
  Agitation occurred in 31.8% of the 113 patients. Multivariate analysis showed that delirium [OR = 24.14; CI95% 5.15 - 113.14; p < 0.001], moderate or severe pain [OR = 5.74; CI95% 1.73 - 19.10; p = 0.004], mechanical ventilation [OR = 10.14; CI95% 2.93 - 35.10; p < 0.001], and smoking habits [OR = 4.49; CI95% 1.33 - 15.17; p = 0.015] were independent factors for agitation, while hyperlactatemia was associated with a lower risk [OR = 0.169; CI95% 0.04 - 0.77; p = 0.021]. Agitated patients had fewer mechanical ventilation-free days at day 7 (p = 0.003).
  The incidence of agitation in the first 7 days after admission to the intensive care unit was high. Delirium, moderate/severe pain, mechanical ventilation, and smoking habits were independent risk factors. Agitated patients had fewer ventilator-free days in the first 7 days.
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brasil.
authors.forename: Thiago Miranda Lopes de
authors.initials: TM
authors.lastname: Almeida
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brasil.
authors.forename: Luciano Cesar Pontes de
authors.initials: LC
authors.lastname: Azevedo
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brasil.
authors.forename: Paulo Maurício Garcia
authors.initials: PM
authors.lastname: Nosé
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brasil.
authors.forename: Flavio Geraldo Resende de
authors.initials: FG
authors.lastname: Freitas
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brasil.
authors.forename: Flávia Ribeiro
authors.initials: FR
authors.lastname: Machado
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016638:Critical Illness; D003693:Delirium / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000453:epidemiology*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors