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. 2021 Aug 26;11(1):17260.
doi: 10.1038/s41598-021-96839-x.

Incidence and predictors of delirium on the intensive care unit in patients with acute kidney injury, insight from a retrospective registry

Markus Jäckel  1   2 , Nico Aicher  3   4 , Jonathan Rilinger  3   4 , Xavier Bemtgen  3   4 , Eugen Widmeier  4   5 , Tobias Wengenmayer  3   4 , Daniel Duerschmied  3   4 , Paul Marc Biever  3   4 , Peter Stachon  3   4 , Christoph Bode  3   4 , Dawid Leander Staudacher  3   4
Affiliations

Incidence and predictors of delirium on the intensive care unit in patients with acute kidney injury, insight from a retrospective registry

Markus Jäckel et al. Sci Rep. .

Abstract

Acute kidney injury (AKI) and delirium are common complications on the intensive care unit (ICU). Few is known about the association of AKI and delirium, as well as about incidence and predictors of delirium in patients with AKI. In this retrospective study, all patients with AKI, as defined by the KDIGO (kidney disease improving global outcome) guideline, treated for more than 24 h on the ICU in an university hospital in 2019 were included and analyzed. Delirium was defined by a NuDesc (Nursing Delirium screening scale) ≥ 2, which is evaluated three times a day in every patient on our ICU as part of daily routine. A total of 383/919 (41.7%) patients developed an AKI during the ICU stay. Delirium was detected in 230/383 (60.1%) patients with AKI. Independent predictors of delirium were: age, psychiatric disease, alcohol abuse, mechanical ventilation, severe shock, and AKI stage II/III (all p < 0.05). The primary cause of illness had no influence on the onset of delirium. Among patients with AKI, the duration of the ICU stay correlated with higher stages of AKI and the presence of delirium (stage I/no delirium: median 1.9 (interquartile range (25th-75th) 1.3-2.9) days; stage II/III/no delirium: 2.6 (1.6-5.5) days; stage I/delirium: 4.1 (2.5-14.3) days; stage II/III/delirium: 6.8 (3.5-11.9) days; all p < 0.01). Delirium, defined as NuDesc ≥ 2 is frequent in patients with AKI on an ICU and independently predicted by higher stages of AKI.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart indicating number of included and excluded patients. Data are given as number of patients.
Figure 2
Figure 2
Delirium incidence and stage of acute kidney injury. Graph shows distribution of delirium positive patients per stage of acute kidney injury. Stage III was separated in patients with and without renal replacement therapy (RRT).
Figure 3
Figure 3
Predictors of delirium on the ICU in patients with acute kidney injury. Graph shows multivariable binary logistic regression analysis with odds ratio (95% confidence interval) of different predictors for delirium in patients with acute kidney injury (AKI) staying for more than 24 h on the ICU.
Figure 4
Figure 4
Duration of stay on the ICU. Graph showing ICU stay of all patients with acute kidney injury (AKI) staying for more than 24 h on the ICU separated by stage of AKI and incidence of delirium.
See this image and copyright information in PMC

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