Delirium in postoperative nonventilated intensive care patients: risk factors and outcomes

被引:62
作者
Serafim, Rodrigo Bernardo [1 ,2 ,3 ,4 ]
Dutra, Maximiliano F. [5 ]
Saddy, Felipe [1 ]
Tura, Bernardo [2 ]
Couto de Castro, Jose Eduardo [5 ]
Villarinho, Luciana C. [5 ]
Santos, Maria da Gloria [5 ]
Bozza, Fernando Augusto [2 ,6 ]
Rocco, Jose Rodolfo [3 ,4 ]
机构
[1] Copa DOr Hosp, Ventilatory Care Unit, Rio De Janeiro, Brazil
[2] DOr Inst Res & Educ, Rio De Janeiro, Brazil
[3] Univ Fed Rio de Janeiro, Dept Internal Med, Hosp Univ Clementino Fraga Filho, Rio De Janeiro, Brazil
[4] Univ Fed Rio de Janeiro, Postgrad Program, Hosp Univ Clementino Fraga Filho, Rio De Janeiro, Brazil
[5] Copa DOr Hosp, Surg Intens Care Unit, Rio De Janeiro, Brazil
[6] Fundacao Oswaldo Cruz, ICU, Inst Pesquisa Clin Evandro Chagas, Rio De Janeiro, Brazil
关键词
Delirium; Postoperative; Surgery; Confusion assessment method;
D O I
10.1186/2110-5820-2-51
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Delirium features can vary greatly depending on the postoperative population studied; however, most studies focus only on high-risk patients. Describing the impact of delirium and risk factors in mixed populations can help in the development of preventive actions. Methods: The occurrence of delirium was evaluated prospectively in 465 consecutive nonventilated postoperative patients admitted to a surgical intensive care unit (SICU) using the confusion assessment method (CAM). Patients with and without delirium were compared. A multiple logistic regression was performed to identify the main risk factors for delirium in the first 24 h of admission to the SICU and the main predictors of outcomes. Results: Delirium was diagnosed in 43 (9.2%) individuals and was more frequent on the second and third days of admission. The presence of delirium resulted in longer lengths of SICU and hospital stays [6 days (3-13) vs. 2 days (1-3), p < 0.001 and 26 days (12-39) vs. 6 days (3-13), p < 0.001, respectively], as well as higher hospital and SICU mortality rates [16.3% vs. 4.0%, p = 0.004 and 6.5% vs. 1.7%, p = 0.042, respectively]. The risk factors for delirium were age (odds ratio (OR), 1.04 [1.02-1.07]), Acute Physiologic Score (APS; OR, 1.11 [1.04-1.2]), emergency surgery (OR, 8.05 [3.58-18.06]), the use of benzodiazepines (OR, 2.28 [1.04-5.00]), and trauma (OR, 6.16 [4.1-6.5]). Conclusions: Delirium negatively impacts postoperative nonventilated patients. Risk factors can be used to detect high-risk patients in a mixed population of SICU patients.
引用
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页码:1 / 6
页数:6
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