Risk factors for delirium after major trauma

Abstract

Background: This study aimed to describe the natural history of delirium after major injury, to identify risk factors that predict the development of postinjury delirium, and to compare outcome measures in subjects with and without delirium.

Methods: A prospective study was performed on patients with an injury severity score of 8 or higher admitted to the trauma intensive care unit (ICU) of a level I trauma center. Patients underwent daily assessments for delirium with the Confusion Assessment Method-ICU.

Results: Sixty-nine patients (53 male) were enrolled. Delirium occurred in 41 (59%) subjects. Logistic regression found lower arrival Glasgow Coma Score (12 +/- 1.0 vs 15 +/- .1; P < .01), increased blood transfusions (2.8 +/- .7 vs .5 +/- .3; P < .01), and higher multiple organ failure score (1.2 +/- .2 vs .1 +/- .1; P < .01) to be the strongest predictors for developing delirium. Outcome measures revealed subjects with delirium had longer hospital stays, longer ICU stays, and were more likely require postdischarge institutionalization.

Conclusions: Delirium is common in the trauma ICU. Higher multiple organ failure score was the strongest predictor of postinjury delirium.