Relationship Between African-American Race and Delirium in the ICU.
Relationship Between African-American Race and Delirium in the ICU.
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DOI：
10.1097/ccm.0000000000001813
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发表时间：
2016-09
影响因子：
8.8
通讯作者：
Boustani MA
中科院分区：
文献类型：
--
作者：
Khan BA;Perkins A;Hui SL;Gao S;Campbell NL;Farber MO;Boustani MA
Delirium is a highly prevalent syndrome of acute brain dysfunction among critically ill patients that has been linked to multiple risk factors such as age, pre-existing cognitive impairment, and use of sedatives; but to date the relationship between race and delirium is unclear. We conducted this study to identify whether African-American race is a risk factor for developing ICU delirium. A prospective cohort study. Medical and Surgical ICUs of a university affiliated, safety-net hospital in Indianapolis, Indiana. 2087 consecutive admissions with 1008 African-Americans admitted to the ICU services from May 2009 to August 2012. None Incident delirium defined as first positive Confusion Assessment Method for the ICU (CAM-ICU) result after an initial negative CAM-ICU; and prevalent delirium defined as positive CAM-ICU on first CAM-ICU assessment. The overall incident delirium rate in African-Americans was 8.7% compared to 10.4% in Caucasians (P: 0.26). The prevalent delirium rate was 14% in both African-Americans and Caucasians (P: 0.95). Significant age and race interactions were detected for incident delirium (P: 0.02), but not for prevalent delirium (P: 0.3). The hazard ratio for incident delirium for African-Americans in the 18–49 years age group compared to Caucasians of similar age was 0.4 (0.1– 0.9). The hazard and odds ratios for incident and prevalent delirium in other groups were not different. African-American race does not confer any additional risk for developing incident or prevalent delirium in the ICU. Instead younger African-Americans tend to have lower rates of incident delirium compared to similar age Caucasians.
