Delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation: a prospective cohort study
- PMID: 35810306
- PMCID: PMC9271245
- DOI: 10.1186/s12890-022-02052-5
Delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation: a prospective cohort study
Abstract
Background: COPD combined with respiratory failure is very common in intensive care unit (ICU). We aimed to evaluate the current status and influencing factors of delirium in elderly COPD patients with undergoing mechanical ventilation.
Methods: Patients with COPD combined with respiratory failure and mechanically ventilated who were admitted to the ICU of our hospital were selected. The characteristics of included patients were assessed. Pearson correlation analysis was performed to evaluate the characteristics of patients and delirium. Logistic regression analysis was conducted to identify the risk factors of delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation.
Results: A total of 237 COPD combined with respiratory failure patients were included, the incidence of delirium was 21.94%. Pearson correlation analysis indicated that age (r = 0.784), BMI (r = 0.709), hypertension (r = 0.696), APACHE II score (r = 0.801), CPOT (r = 0.513), sedation(r = 0.626) and PaO2 (r = 0.611) were all correlated with the occurrence of delirium (all p < 0.05). Logistic regression analysis indicated that age ≥ 75y (OR 3.112, 95% CI 2.144-4.602), BMI ≤ 19 kg/m2 (OR 2.742, 95% CI 1.801-3.355), hypertension(OR 1.909, 95% CI 1.415-2.421), APACHE II score ≥ 15 (OR 2.087, 95% CI 1.724-2.615), CPOT ≥ 5 (OR 1.778, 95% CI 1.206-2.641), sedation(OR 3.147, 95% CI 2.714-3.758), PaO2 ≤ 75 mmHg(OR 2.196, 95%CI 1.875-3.088) were the risk factors of delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation (all p < 0.05).
Conclusions: Delirium is common in patients with COPD and respiratory failure undergoing mechanical ventilation, and there are many related influencing factors. Medical staff should pay more attention to patients with risk factors and take intervention measures as soon as possible to reduce the incidence of delirium.
Keywords: COPD; Care; Delirium; Elder; Management; Mechanical ventilation; Prevention; Respiratory failure.
© 2022. The Author(s).
Conflict of interest statement
The authors declare that they have no competing interests.
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References
-
- Zheng M, Dong L, Hao Z, Wang S. Efficacy and safety of high-flow oxygen therapy application for chronic obstructive pulmonary disease with acute hypercapnic respiratory failure: a protocol for systematic review and meta-analysis. Med. 2021;100(15):e25489. doi: 10.1097/MD.0000000000025489. - DOI - PMC - PubMed
-
- Plotnikow GA, Accoce M, Fredes S, Tiribelli N, Setten M, Dorado J, Guaymas M, Ilutovich S, Rodriguez PO, Cesio CE, et al. High-flow oxygen therapy application in chronic obstructive pulmonary disease patients with acute hypercapnic respiratory failure: a multicenter study. Crit Care Explor. 2021;3(2):e0337. doi: 10.1097/CCE.0000000000000337. - DOI - PMC - PubMed
-
- Johnson SA, Rupp AB, Rupp KL, Reddy S. Clinical outcomes and costs associated with procalcitonin utilization in hospitalized patients with pneumonia, heart failure, viral respiratory infection, or chronic obstructive pulmonary disease. Intern Emerg Med. 2021;16(3):677–686. doi: 10.1007/s11739-020-02618-3. - DOI - PubMed
-
- Lin SH, He YP, Lian JJ, Chu CK. Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin's adjunct role. Libyan J Med. 2021;16(1):1961382. doi: 10.1080/19932820.2021.1961382. - DOI - PMC - PubMed
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