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. 2015 May;16(4):303-309.
doi: 10.1097/PCC.0000000000000356.

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

Gabrielle Silver #  1 , Chani Traube #  1 , Linda M Gerber  1 , Xuming Sun  1 , Julia Kearney  2 , Anita Patel  3 , Bruce Greenwald  1
Affiliations

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

Gabrielle Silver et al. Pediatr Crit Care Med. 2015 May.

Abstract

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.

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Figures

Figure 1
Figure 1
Subject recruitment flow
Figure 2
Figure 2
Risk factors associated with diagnosis of delirium (Data reported as percentage of entire sample, total n=252 encounters)
Figure 3
Figure 3
Association between subjects diagnosed with delirium during this study and hospital LOS (*one outlier (LOS = 267 days) was included in analysis, but removed from this figure).
See this image and copyright information in PMC

Comment in

  • On risk factors for pediatric delirium at noon.
    Schieveld JN, van Zwieten JJ. Schieveld JN, et al. Pediatr Crit Care Med. 2015 May;16(4):375-6. doi: 10.1097/PCC.0000000000000371. Pediatr Crit Care Med. 2015. PMID: 25946261 No abstract available.
  • Is It Time for Food of the Soul in Pediatric Critical Care?
    Spentzas T. Spentzas T. Pediatr Crit Care Med. 2015 Oct;16(8):797-8. doi: 10.1097/PCC.0000000000000509. Pediatr Crit Care Med. 2015. PMID: 26427821 No abstract available.
  • The authors reply.
    Silver G, Traube C. Silver G, et al. Pediatr Crit Care Med. 2015 Oct;16(8):798-9. doi: 10.1097/PCC.0000000000000534. Pediatr Crit Care Med. 2015. PMID: 26427822 No abstract available.

References

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    1. Pisani MA, Kong SYJ, Kasl SV, Murphy TE, Araujo KLB, Van Ness PH. Days of delirium are associated with 1-year mortality in an older intensive care unit population. Am J Respir Crit Care Med. 2009 Dec 1;180(11):1092–7. - PMC - PubMed
    1. Barr J, Fraser GL, Puntillo K, Ely EW, Gelinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41(1):263–306. - PubMed
    1. Williams ST. Pathophysiology of Encephalopathy and Delirium. J Clin Neurophysiol. 2013;30(5):435–7. - PubMed

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