Risk factors associated with the development of delirium in general ICU patients. A prospective observational study

PLoS One. 2021 Sep 2;16(9):e0255522. doi: 10.1371/journal.pone.0255522. eCollection 2021.

Abstract

Objective: We aimed to analyze risk factors related to the development of delirium, aiming for early intervention in patients with greater risk.

Material and methods: Observational study, including prospectively collected patients treated in a single general ICU. These were classified into two groups, according to whether they developed delirium or not (screening performed using CAM-ICU tool). Demographics and clinical data were analyzed. Multivariate logistic regression analyses were performed to quantify existing associations.

Results: 1462 patients were included. 93 developed delirium (incidence: 6.3%). These were older, scored higher on the Clinical Frailty Scale, on the risk scores on admission (SAPS-3 and SOFA), and had a greater number of organ failures (OF). We observed more incidence of delirium in patients who (a) presented more than two OF (20.4%; OR 4.9; CI95%: 2.9-8.2), and (b) were more than 74 years old albeit having <2 OF (8.6%; OR 2.1; CI95%: 1.3-3.5). Patients who developed delirium had longer ICU and hospital length-of-stays and a higher rate of readmission.

Conclusions: The highest risk observed for developing delirium clustered in patients who presented more than 2 OF and patients over 74 years old. The detection of patients at high risk for developing delirium could imply a change in management and improved quality of care.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Delirium / etiology*
  • Delirium / pathology
  • Female
  • Frailty
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Multiple Organ Failure / pathology
  • Multiple Organ Failure / psychology*
  • Prospective Studies
  • Quality Improvement
  • Risk Factors

Grants and funding

Financial support is provided to cover publication fees, through Fundación para la Investigación e Innovación Biomédica of Hospital Universitario Infanta Sofia & Hospital Universitario del Henares (FIIB HUIS HHEN, Director: Marta Neira Álvarez) in the form of one of the prizes of RESEARCH AWARDS 2020, promoted by this Foundation (certificate issued in Madrid on 12 April 2021), awarded to BLV. No additional external funding was received for this study.