Pediatric delirium and associated risk factors: a single-center prospective observational study.

OBJECTIVE To describe a single-institution pilot study regarding prevalence and risk factors for delirium in critically ill children. DESIGN A prospective observational study, with secondary analysis of data collected during the validation of a pediatric delirium screening tool, the Cornell Assessment of Pediatric Delirium. SETTING This study took place in the PICU at an urban academic medical center. PATIENTS Ninety-nine consecutive patients, ages newborn to 21 years. INTERVENTION Subjects underwent a psychiatric evaluation for delirium based on the Diagnostic and Statistical Manual IV criteria. MEASUREMENTS AND MAIN RESULTS Prevalence of delirium in this sample was 21%. In multivariate analysis, risk factors associated with the diagnosis of delirium were presence of developmental delay, need for mechanical ventilation, and age 2-5 years. CONCLUSIONS In our institution, pediatric delirium is a prevalent problem, with identifiable risk factors. Further large-scale prospective studies are required to explore multi-institutional prevalence, modifiable risk factors, therapeutic interventions, and effect on long-term outcomes.