Risk factors and outcomes of sepsis-associated delirium in intensive care unit patients: A secondary data analysis

Abstract

Objective: To identify the risk factors of sepsis-associated delirium and determine their effect on intensive care unit adult patient outcomes.

Design: A secondary analysis of data from system development studies.

Setting: Korean intensive care unit patients in a university hospital who were diagnosed with sepsis.

Methods: The risk factors for sepsis-associated delirium were classified into patient factors and sepsis clinical features and were analysed using hierarchical logistic regression analysis. Outcomes included in-hospital mortality, 30-day in-hospital mortality, duration of mechanical ventilation, length of stay in the intensive care unit, length of hospital stay, total medical expenses, discharge placement, re-hospitalisation and visits to the emergency department after discharge.

Results: The risk factor for sepsis-associated delirium including patients aged 65 ≥years, dependent activity and high nursing needs (patient factors), low level of consciousness, tachypnoea, and thrombocytopaenia (clinical features of sepsis). Use of vasopressors/inotropes and albumin decreased the risk of sepsis-associated delirium. Mechanical ventilation duration was prolonged and discharge to skilled nursing facilities was increased by sepsis-associated delirium.

Conclusions: The risk factors for sepsis-associated delirium increased as the severity of condition for patients with sepsis increased. Early identification of risk factors associated with sepsis-associated delirium may improve patient outcomes.

Keywords: Delirium; Risk factors; Sepsis; Sepsis-associated encephalopathy; Treatment outcome.