Delirium in postoperative nonventilated intensive care patients: risk factors and outcomes

作者:Serafim Rodrigo Bernardo*; Dutra Maximiliano F; Saddy Felipe; Tura Bernardo; Couto de Castro Jose Eduardo; Villarinho Luciana C; Santos Maria da Gloria; Bozza Fernando Augusto; Rocco Jose Rodolfo
来源:Annals of Intensive Care, 2012, 2(1): 51.
DOI:10.1186/2110-5820-2-51

摘要

Background: Delirium features can vary greatly depending on the postoperative population studied; however, most studies focus only on high-risk patients. Describing the impact of delirium and risk factors in mixed populations can help in the development of preventive actions. %26lt;br%26gt;Methods: The occurrence of delirium was evaluated prospectively in 465 consecutive nonventilated postoperative patients admitted to a surgical intensive care unit (SICU) using the confusion assessment method (CAM). Patients with and without delirium were compared. A multiple logistic regression was performed to identify the main risk factors for delirium in the first 24 h of admission to the SICU and the main predictors of outcomes. %26lt;br%26gt;Results: Delirium was diagnosed in 43 (9.2%) individuals and was more frequent on the second and third days of admission. The presence of delirium resulted in longer lengths of SICU and hospital stays [6 days (3-13) vs. 2 days (1-3), p %26lt; 0.001 and 26 days (12-39) vs. 6 days (3-13), p %26lt; 0.001, respectively], as well as higher hospital and SICU mortality rates [16.3% vs. 4.0%, p = 0.004 and 6.5% vs. 1.7%, p = 0.042, respectively]. The risk factors for delirium were age (odds ratio (OR), 1.04 [1.02-1.07]), Acute Physiologic Score (APS; OR, 1.11 [1.04-1.2]), emergency surgery (OR, 8.05 [3.58-18.06]), the use of benzodiazepines (OR, 2.28 [1.04-5.00]), and trauma (OR, 6.16 [4.1-6.5]). %26lt;br%26gt;Conclusions: Delirium negatively impacts postoperative nonventilated patients. Risk factors can be used to detect high-risk patients in a mixed population of SICU patients.

  • 出版日期2012