Factors associated with persistent delirium after intensive care unit admission in an older medical patient population.
Factors associated with persistent delirium after intensive care unit admission in an older medical patient population.
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DOI：
10.1016/j.jcrc.2010.02.009
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发表时间：
2010-09
影响因子：
3.7
通讯作者：
Van Ness, Peter H
中科院分区：
文献类型：
--
作者：
Pisani, Margaret A;Murphy, Terrence E;Araujo, Katy L B;Van Ness, Peter H
This study was designed to identify factors associated with persistent delirium in an older medical ICU population. Prospective cohort study of 309 consecutive medical ICU patients age ≥60. Persistent delirium was defined as delirium occurring in the ICU and continuing upon discharge to the ward. The Confusion Assessment Method (CAM) was used to assess for delirium. Patient demographics, severity of illness, and medication data were collected. Univariate and multivariate analysis were used to assess factors associated with persistent delirium. Of 309 consecutive admissions to the ICU, 173 patients had ICU delirium, survived the ICU stay, and provided ward data. One-hundred patients (58%) had persistent delirium. In a multivariable logistic regression model, factors significantly associated with persistent delirium included age >75 years (OR, 2.52, 95% CI, 1.23–5.16), opioid (morphine equivalent) dose >54 mg/day (OR, 2.90, 95% CI, 1.15–7.28), and haloperidol (OR, 2.88, 95% CI, 1.38–6.02); change in code status to ‘Do Not Resuscitate’ (DNR) (OR, 2.62, 95% CI 0.95–7.35) and dementia (OR, 1.93, 95% CI 0.95–3.93) had less precise associations. Age, use of opioids and haloperidol were associated with persistent delirium. Further research is needed regarding the use of haloperidol and opioids on persistent delirium.
