Correlates & Risk factors for ICU delirium

Background: Delirium is a disturbance in attention awareness which develops in short period of time & fluctuate in severity. Its associated with functional disability, cognitive impairment, dementia & death in ICU inpatients. Objective: To Study the incidence & risk factors of delirium in intensive care unit (ICU) patients . Method: In an observational, non-interventional study, 486 ICU patients were assessed in a tertiary care center for delirium. 163 patients had a Richmond Agitation Sedation Scale value (RASS) ≤-3 were excluded from the study. Remaining, 323 subjects were evaluated for delirium using CAM-ICU (Confusion Assessment Method for ICU). Apart from socio-demographic profile, admission details, clinical profiles, use of invasive mechanical ventilation, invasive devices & medication were examined. SPSS version 14.0 was used for statistical analysis. Results: Among 323 subjects evaluated by CAM-ICU, 31 (9.6%) patients had delirium. Medical causes being most common reason for ICU admission & sepsis being the commonest medical ailment. Use of Invasive mechanical ventilation, central vein catheter, arterial catheter, urinary catheter & midazolam use; significantly increased risk of delirium. Prolonged ICU (5 vs 3) and hospital (10 vs 6) length of stay (LOS) was associated with delirium. Conclusion: One in every ten patients admitted to an intensive care unit develop delirium, which is postulated to be associated with poor prognosis, cognitive impairment & mortality risk. Burden of delirium can be reduced by controlling for several modifiable risk factors.