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. 2009 Dec 1;180(11):1092-7.
doi: 10.1164/rccm.200904-0537OC. Epub 2009 Sep 10.

Days of delirium are associated with 1-year mortality in an older intensive care unit population

Margaret A Pisani  1 , So Yeon Joyce Kong, Stanislav V Kasl, Terrence E Murphy, Katy L B Araujo, Peter H Van Ness
Affiliations

Days of delirium are associated with 1-year mortality in an older intensive care unit population

Margaret A Pisani et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Delirium is a frequent occurrence in older intensive care unit (ICU) patients, but the importance of the duration of delirium in contributing to adverse long-term outcomes is unclear.

Objectives: To examine the association of the number of days of ICU delirium with mortality in an older patient population.

Methods: We performed a prospective cohort study in a 14-bed ICU in an urban acute care hospital. The patient population comprised 304 consecutive admissions 60 years of age and older.

Measurements and main results: The main outcome was 1-year mortality after ICU admission. Patients were assessed daily for delirium with the Confusion Assessment Method for the ICU and a validated chart review method. The median duration of ICU delirium was 3 days (range, 1-46 d). During the follow-up period, 153 (50%) patients died. After adjusting for relevant covariates, including age, severity of illness, comorbid conditions, psychoactive medication use, and baseline cognitive and functional status, the number of days of ICU delirium was significantly associated with time to death within 1 year post-ICU admission (hazard ratio, 1.10; 95% confidence interval, 1.02-1.18).

Conclusions: Number of days of ICU delirium was associated with higher 1-year mortality after adjustment for relevant covariates in an older ICU population. Investigations should be undertaken to reduce the number of days of ICU delirium and to study the impact of this reduction on important health outcomes, including mortality and functional and cognitive status.

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Figures

Figure 1.
Figure 1.
Patient enrollment screening and eligibility flow diagram.
Figure 2.
Figure 2.
Kaplan-Meier survival curve for 1-year mortality post–intensive care unit (ICU) admission (ICU delirium days predictor). Log-rank chi-square statistic = 28.3; degrees of freedom = 3; P < 001.
See this image and copyright information in PMC

Comment in

References

    1. Ely EW, Siegel MD, Inouye SK. Delirium in the intensive care unit: an under-recognized syndrome of organ dysfunction. Semin Respir Crit Care Med 2001;22:115–126. - PubMed
    1. McNicoll L, Pisani MA, Zhang Y, Ely EW, Siegel MD, Inouye SK. Delirium in the intensive care unit: Occurrence and clinical course in older patients. J Am Geriatr Soc 2003;51:591–598. - PubMed
    1. Pisani MA, Murphy TE, Van Ness PH, Araujo KL, Inouye SK. Characteristics associated with delirium in older patients in a medical intensive care unit. Arch Intern Med 2007;167:1629–1634. - PubMed
    1. Ely EW, Gautam S, Margolin R, Francis J, May L, Speroff T, Truman B, Dittus R, Bernard R, Inouye SK. The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med 2001;27:1892–1900. - PMC - PubMed
    1. Ely EW, Jackson J, Gordon S, Shintani A, May L, Truman B, Dittus R, Gautam S, Bernard G, Speroff T, et al. Long-term neuropsychological deficits following delirium in mechanically ventilated ICU patients [abstract]. Am J Respir Crit Care Med 2002;165:A30.

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