Risk factors for delirium in ICU
Delirium is a syndrome characterized by acute brain dysfunction. This syndrome is under-recognized in the intensive care unit (ICU) with not fully elucidated causing mechanisms. The identification of risk factors associated with delirium may prevent the onset of delirium and help in the management. Aim of this study is to estimate the incidence of delirium in ICU and to identify related risk factors in two different ICU.
This study was carried out in collaboration with the Intensive Care Unit of Santa Chiara Hospital, Pisa University, Italy, and the Intensive Care Unit of South Egypt Cancer Institute, Assiut University, Egypt. During a 3 months research period patients admitted to the referred ICU were enrolled. The Confusion Assessment Method for ICU was used as methodology for diagnosing delirium. Patients were assessed twice a day. Haemodynamic parameters, arterial blood gas values, electrolytes, presence of sepsis, type of ventilation and type of sedation were assessed at the same intervals. We also recorded daily laboratory investigations, age, diagnosis, length of ICU stay, incidence of complications and general condition at discharge. Data were statistically analyzed with Mann-Whitney test, Wilcoxon test and the Chi-square test.
111 patients in the first ICU and 51 patients in the second ICU were enrolled. ICU delirium was found to be significantly related to sepsis, mechanical ventilation and sedation (P-value <0,05).
We believe that the early identification of risk factors that may lead to the occurrence of delirium in ICU, associated with the appropriate treatment may reduce the incidence of delirium in ICU and delirium related complications.