Intensive Care Medicine

, Volume 33, Issue 1, pp 66–73 | Cite as

Incidence, risk factors and consequences of ICU delirium

  • Sébastien Ouimet
  • Brian P. Kavanagh
  • Stewart B. Gottfried
  • Yoanna Skrobik
Original

Abstract

Objective

Delirium in the critically ill is reported in 11–80% of patients. We estimated the incidence of delirium using a validated scale in a large cohort of ICU patients and determined the associated risk factors and outcomes.

Design and setting

Prospective study in a 16-bed medical-surgical intensive care unit (ICU).

Patients

820 consecutive patients admitted to ICU for more than 24 h.

Interventions

Tools used were: the Intensive Care Delirium Screening Checklist for delirium, Richmond Agitation and Sedation Scale for sedation, and Numerical Rating Scale for pain. Risk factors were evaluated with univariate and multivariate analysis, and factors influencing mortality were determined using Cox regression.

Results

Delirium occurred in 31.8% of 764 patients. Risk of delirium was independently associated with a history of hypertension (OR 1.88, 95% CI 1.3–2.6), alcoholism (2.03, 1.2–3.2), and severity of illness (1.25, 1.03–1.07 per 5-point increment in APACHE II score) but not with age or corticosteroid use. Sedatives and analgesics increased the risk of delirium when used to induce coma (OR 3.2, 95% CI 1.5–6.8), and not otherwise. Delirium was linked to longer ICU stay (11.5 ± 11.5 vs. 4.4 ± 3.9 days), longer hospital stay (18.2 ± 15.7 vs. 13.2 ± 19.4 days), higher ICU mortality (19.7% vs. 10.3%), and higher hospital mortality (26.7% vs. 21.4%).

Conclusion

Delirium is associated with a history of hypertension and alcoholism, higher APACHE II score, and with clinical effects of sedative and analgesic drugs.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Sébastien Ouimet
    • 2
  • Brian P. Kavanagh
    • 3
    • 4
  • Stewart B. Gottfried
    • 5
    • 6
  • Yoanna Skrobik
    • 1
    • 2
    • 6
  1. 1.Intensive Care UnitMaisonneuve-Rosemont HospitalMontréalCanada
  2. 2.Department of MedicineUniversity of MontrealMontrealCanada
  3. 3.Departments of Anesthesia, Medicine and PhysiologyUniversity of TorontoTorontoCanada
  4. 4.Department of Critical Care MedicineHospital for Sick ChildrenTorontoCanada
  5. 5.Meakins-Christie LaboratoriesMontrealCanada
  6. 6.Department of MedicineMcGill UniversityMontrealCanada

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