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Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium

Background: Delirium is a common occurrence in patients admitted to the intensive care unit and is related to mortality and morbidity. Malnutrition is a predisposing factor for the development of delirium. Nevertheless, whether the nutritional status on admission anticipates the development of delir...

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Autores principales: Sugita, Yurina, Miyazaki, Tetsuro, Shimada, Kazunori, Shimizu, Megumi, Kunimoto, Mitsuhiro, Ouchi, Shohei, Aikawa, Tatsuro, Kadoguchi, Tomoyasu, Kawaguchi, Yuko, Shiozawa, Tomoyuki, Takasu, Kiyoshi, Hiki, Masaru, Takahashi, Shuhei, Sumiyoshi, Katsuhiko, Iwata, Hiroshi, Daida, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267104/
https://www.ncbi.nlm.nih.gov/pubmed/30413062
http://dx.doi.org/10.3390/nu10111712
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author Sugita, Yurina
Miyazaki, Tetsuro
Shimada, Kazunori
Shimizu, Megumi
Kunimoto, Mitsuhiro
Ouchi, Shohei
Aikawa, Tatsuro
Kadoguchi, Tomoyasu
Kawaguchi, Yuko
Shiozawa, Tomoyuki
Takasu, Kiyoshi
Hiki, Masaru
Takahashi, Shuhei
Sumiyoshi, Katsuhiko
Iwata, Hiroshi
Daida, Hiroyuki
author_facet Sugita, Yurina
Miyazaki, Tetsuro
Shimada, Kazunori
Shimizu, Megumi
Kunimoto, Mitsuhiro
Ouchi, Shohei
Aikawa, Tatsuro
Kadoguchi, Tomoyasu
Kawaguchi, Yuko
Shiozawa, Tomoyuki
Takasu, Kiyoshi
Hiki, Masaru
Takahashi, Shuhei
Sumiyoshi, Katsuhiko
Iwata, Hiroshi
Daida, Hiroyuki
author_sort Sugita, Yurina
collection PubMed
description Background: Delirium is a common occurrence in patients admitted to the intensive care unit and is related to mortality and morbidity. Malnutrition is a predisposing factor for the development of delirium. Nevertheless, whether the nutritional status on admission anticipates the development of delirium in patients with acute cardiovascular diseases remains unknown. Objective: This study aims to assess the correlation between the nutritional status on admission using the nutritional index and the development of delirium in the coronary intensive care unit. Design: We examined 653 consecutive patients (mean age: 70 ± 14 years) admitted to the coronary intensive care unit of Juntendo University Hospital between January 2015 and December 2016. We evaluated three nutritional indices frequently used to assess the nutritional status, i.e., Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT). We defined delirium as patients with a delirium score >4 using the Intensive Care Delirium Screening Checklist. Results: Delirium was present in 58 patients. All nutritional indices exhibited a tendency for malnutrition in the delirium group compared with the non-delirium group (GNRI, 86.5 ± 9.38 versus 91.6 ± 9.89; PNI, 36.4 ± 6.95 versus 41.6 ± 7.62; CONUT, 5.88 ± 3.00 versus 3.61 ± 2.56; for all, p < 0.001). Furthermore, the maximum delirium score increased progressively from the low- to the high-risk group, as evaluated by each nutritional index (GNRI, PNI, CONUT; for all, p < 0.001). A multivariate analysis revealed that the PNI and CONUT were independent risk factors for the occurrence of delirium. Conclusions: A marked correlation exists between the nutritional index on admission, especially PNI and CONUT, and the development of delirium in patients with acute cardiovascular diseases, suggesting that malnutrition assessment upon admission could help identify patients at high risk of developing delirium.
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spelling pubmed-62671042018-12-06 Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium Sugita, Yurina Miyazaki, Tetsuro Shimada, Kazunori Shimizu, Megumi Kunimoto, Mitsuhiro Ouchi, Shohei Aikawa, Tatsuro Kadoguchi, Tomoyasu Kawaguchi, Yuko Shiozawa, Tomoyuki Takasu, Kiyoshi Hiki, Masaru Takahashi, Shuhei Sumiyoshi, Katsuhiko Iwata, Hiroshi Daida, Hiroyuki Nutrients Article Background: Delirium is a common occurrence in patients admitted to the intensive care unit and is related to mortality and morbidity. Malnutrition is a predisposing factor for the development of delirium. Nevertheless, whether the nutritional status on admission anticipates the development of delirium in patients with acute cardiovascular diseases remains unknown. Objective: This study aims to assess the correlation between the nutritional status on admission using the nutritional index and the development of delirium in the coronary intensive care unit. Design: We examined 653 consecutive patients (mean age: 70 ± 14 years) admitted to the coronary intensive care unit of Juntendo University Hospital between January 2015 and December 2016. We evaluated three nutritional indices frequently used to assess the nutritional status, i.e., Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT). We defined delirium as patients with a delirium score >4 using the Intensive Care Delirium Screening Checklist. Results: Delirium was present in 58 patients. All nutritional indices exhibited a tendency for malnutrition in the delirium group compared with the non-delirium group (GNRI, 86.5 ± 9.38 versus 91.6 ± 9.89; PNI, 36.4 ± 6.95 versus 41.6 ± 7.62; CONUT, 5.88 ± 3.00 versus 3.61 ± 2.56; for all, p < 0.001). Furthermore, the maximum delirium score increased progressively from the low- to the high-risk group, as evaluated by each nutritional index (GNRI, PNI, CONUT; for all, p < 0.001). A multivariate analysis revealed that the PNI and CONUT were independent risk factors for the occurrence of delirium. Conclusions: A marked correlation exists between the nutritional index on admission, especially PNI and CONUT, and the development of delirium in patients with acute cardiovascular diseases, suggesting that malnutrition assessment upon admission could help identify patients at high risk of developing delirium. MDPI 2018-11-08 /pmc/articles/PMC6267104/ /pubmed/30413062 http://dx.doi.org/10.3390/nu10111712 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sugita, Yurina
Miyazaki, Tetsuro
Shimada, Kazunori
Shimizu, Megumi
Kunimoto, Mitsuhiro
Ouchi, Shohei
Aikawa, Tatsuro
Kadoguchi, Tomoyasu
Kawaguchi, Yuko
Shiozawa, Tomoyuki
Takasu, Kiyoshi
Hiki, Masaru
Takahashi, Shuhei
Sumiyoshi, Katsuhiko
Iwata, Hiroshi
Daida, Hiroyuki
Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium
title Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium
title_full Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium
title_fullStr Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium
title_full_unstemmed Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium
title_short Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium
title_sort correlation of nutritional indices on admission to the coronary intensive care unit with the development of delirium
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267104/
https://www.ncbi.nlm.nih.gov/pubmed/30413062
http://dx.doi.org/10.3390/nu10111712
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