Incidence and risk factors for delirium development in ICU patients - a prospective observational study.
OBJECTIVE
Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients.


METHODS
A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period. We evaluated the incidence of delirium and its predisposing and precipitating risk factors. All patients were assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU).


CONCLUSIONS
Of the total of 332 patients with a median APACHE II (the Acute Physiology and Chronic Health Evaluation) score of 12, who were evaluated for delirium, 48 could not be assessed using CAM-ICU (47 due to prolonged coma, 1 due to language barriers). The incidence of delirium was 26.1%, with trauma and medical patients being more likely to develop delirium than surgical patients. Risk of delirium was significantly associated with age ≥ 65 years, and alcohol abuse in their anamnesis, with APACHE II score on admission, and with the use of sedatives and/or vasopressors. Delirious patients who remained in the ICU for a prolonged period showed a greater need for ventilator support and had a greater ICU-mortality.
Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic.|Departments of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava, Czech Republic.|Department of Intensive Medicine, Emergency Medicine and Forensic Studies, University of Ostrava, Czech Republic.
Marcela
M
Kanova
Departments of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava, Czech Republic.|Department of Intensive Medicine, Emergency Medicine and Forensic Studies, University of Ostrava, Czech Republic.
Peter
P
Sklienka
Departments of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava, Czech Republic.|Department of Intensive Medicine, Emergency Medicine and Forensic Studies, University of Ostrava, Czech Republic.
Kula
K
Roman
Institute for Research and Application of Fuzzy Modeling, University of Ostrava, CE IT4Innovations, Czech Republic.
Michal
M
Burda
Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic.
Jana
J
Janoutova
D018806:APACHE; D000368:Aged; D016638:Critical Illness / Q000628:therapy*; D018153:Czech Republic; D003693:Delirium / Q000453:epidemiology / Q000209:etiology* / Q000451:nursing*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000706:statistics & numerical data*; D012307:Risk Factors
CAM-ICU diagnostic test; artificial ventilation; critically ill patients; delirium; predisposing and precipitating risk factors