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Delirium in a Latin American intensive care unit. A prospective cohort study of mechanically ventilated patients
OBJECTIVE: To establish the prevalence of delirium in a general intensive care unit and to identify associated factors, clinical expression and the influence on outcomes. METHODS: This was a prospective cohort study in a medical surgical intensive care unit. The Richmond Agitation-Sedation Scale and...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Associação de Medicina Intensiva Brasileira -
AMIB
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632977/ https://www.ncbi.nlm.nih.gov/pubmed/29044304 http://dx.doi.org/10.5935/0103-507X.20170058 |
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author | Mesa, Patricia Previgliano, Ignacio José Altez, Sonia Favretto, Silvina Orellano, María Lecor, Cinthya Soca, Ana Wesley, Ely |
author_facet | Mesa, Patricia Previgliano, Ignacio José Altez, Sonia Favretto, Silvina Orellano, María Lecor, Cinthya Soca, Ana Wesley, Ely |
author_sort | Mesa, Patricia |
collection | PubMed |
description | OBJECTIVE: To establish the prevalence of delirium in a general intensive care unit and to identify associated factors, clinical expression and the influence on outcomes. METHODS: This was a prospective cohort study in a medical surgical intensive care unit. The Richmond Agitation-Sedation Scale and Confusion Assessment Method for the Intensive Care Unit were used daily to identify delirium in mechanically ventilated patients. RESULTS: In this series, delirium prevalence was 80% (N = 184 delirious patients out of 230 patients). The number of patients according to delirium psychomotor subtypes was as follows: 11 hyperactive patients (6%), 9 hypoactive patients (5%) and 160 mixed patients (89%). Multiple logistic regression modeling using delirium as the dependent outcome variable (to study the risk factors for delirium) revealed that age > 65 years, history of alcohol consumption, and number of mechanical ventilation days were independent variables associated with the development of delirium. The multiple logistic regression model using hospital mortality as the dependent outcome variable (to study the risk factors for death) showed that severity of illness, according to the Acute Physiology and Chronic Health Evaluation II, mechanical ventilation for more than 7 days, and sedation days were all independent predictors for excess hospital mortality. CONCLUSION: This Latin American prospective cohort investigation confirmed specific factors important for the development of delirium and the outcome of death among general intensive care unit patients. In both analyses, we found that the duration of mechanical ventilation was a predictor of untoward outcomes. |
format | Online Article Text |
id | pubmed-5632977 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Associação de Medicina Intensiva Brasileira -
AMIB |
record_format | MEDLINE/PubMed |
spelling | pubmed-56329772017-10-12 Delirium in a Latin American intensive care unit. A prospective cohort study of mechanically ventilated patients Mesa, Patricia Previgliano, Ignacio José Altez, Sonia Favretto, Silvina Orellano, María Lecor, Cinthya Soca, Ana Wesley, Ely Rev Bras Ter Intensiva Original Articles OBJECTIVE: To establish the prevalence of delirium in a general intensive care unit and to identify associated factors, clinical expression and the influence on outcomes. METHODS: This was a prospective cohort study in a medical surgical intensive care unit. The Richmond Agitation-Sedation Scale and Confusion Assessment Method for the Intensive Care Unit were used daily to identify delirium in mechanically ventilated patients. RESULTS: In this series, delirium prevalence was 80% (N = 184 delirious patients out of 230 patients). The number of patients according to delirium psychomotor subtypes was as follows: 11 hyperactive patients (6%), 9 hypoactive patients (5%) and 160 mixed patients (89%). Multiple logistic regression modeling using delirium as the dependent outcome variable (to study the risk factors for delirium) revealed that age > 65 years, history of alcohol consumption, and number of mechanical ventilation days were independent variables associated with the development of delirium. The multiple logistic regression model using hospital mortality as the dependent outcome variable (to study the risk factors for death) showed that severity of illness, according to the Acute Physiology and Chronic Health Evaluation II, mechanical ventilation for more than 7 days, and sedation days were all independent predictors for excess hospital mortality. CONCLUSION: This Latin American prospective cohort investigation confirmed specific factors important for the development of delirium and the outcome of death among general intensive care unit patients. In both analyses, we found that the duration of mechanical ventilation was a predictor of untoward outcomes. Associação de Medicina Intensiva Brasileira - AMIB 2017 /pmc/articles/PMC5632977/ /pubmed/29044304 http://dx.doi.org/10.5935/0103-507X.20170058 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Mesa, Patricia Previgliano, Ignacio José Altez, Sonia Favretto, Silvina Orellano, María Lecor, Cinthya Soca, Ana Wesley, Ely Delirium in a Latin American intensive care unit. A prospective cohort study of mechanically ventilated patients |
title | Delirium in a Latin American intensive care unit. A
prospective cohort study of mechanically ventilated patients |
title_full | Delirium in a Latin American intensive care unit. A
prospective cohort study of mechanically ventilated patients |
title_fullStr | Delirium in a Latin American intensive care unit. A
prospective cohort study of mechanically ventilated patients |
title_full_unstemmed | Delirium in a Latin American intensive care unit. A
prospective cohort study of mechanically ventilated patients |
title_short | Delirium in a Latin American intensive care unit. A
prospective cohort study of mechanically ventilated patients |
title_sort | delirium in a latin american intensive care unit. a
prospective cohort study of mechanically ventilated patients |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632977/ https://www.ncbi.nlm.nih.gov/pubmed/29044304 http://dx.doi.org/10.5935/0103-507X.20170058 |
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