The Impact of Delirium on Clinical Outcomes in Multi-Center Thai Surgical Intensive Care Units: a Prospective Cohort Study
Pipanmekaporn, T.; Chittawatanarat, K.; Chaiwat, O.; Thawitsri, T.; Wacharasint, P.; Kongsayreepong, S.
Journal of the Medical Association of Thailand 99(Suppl 6): S226-S232
2016
ISSN/ISBN: 0125-2208 PMID: 29906384 Document Number: 17557
Delirium in intensive care units (ICU) increases risks in prolonged mechanical ventilation, hospitalization, and A multi-center, prospective cohort study was conducted between April 2011 and January 2013. All A total of 4,652 patients were included. One hundred and sixty-three patients were diagnosed delirium (3.5%, 163 of 4,652). Patients who experienced delirium during ICU admission were significantly older (65.0+15.8 years versus 61.6+17.3 years, p = 0.013), had higher American Society of Anesthesiologists physical status (24.3% versus 12.2%, p<0.001), higher Acute Physiology and Chronic Health Evaluation II score (16 (12-23) versus 10 (7-15), p<0.001), and higher Sequential Organ Failure Assessment score (5 (2-8) versus 2 (1-5), p<0.001) compared to non-delirium. Delirious patients also had higher ventilator days (7 (4-17) versus 2 (1-4), p<0.001, longer length of hospital stay (22 (14-34) versus 15 (9-26), p<0.001) and higher ICU mortality (24% versus 9%, p<0.001), and 28-day mortality (28% versus 13%, p<0.001). Patients who developed delirium in the intensive care unit were associated with increased 28-day mortality (adjusted HR = 2.47, 95% CI: 1.13-5.41, p = 0.023). Delirium in an ICU was a major predictor of hospital mortality after adjusted for relevant covariates. Routine