Incidence, risk factors and consequences of ICU delirium
Abstract
Objective Delirium in the critically ill is reported in 11-80% of patients. We estimated the incidence of delirium using a validated scale in a large cohort of ICU patients and determined the associated risk factors and outcomes.Design and setting Prospective study in a 16-bed medical-surgical intensive care unit (ICU).Patients 820 consecutive patients admitted to ICU for more than 24 h.Interventions Tools used were: the Intensive Care Delirium Screening Checklist for delirium, Richmond Agitation and Sedation Scale for sedation, and Numerical Rating Scale for pain. Risk factors were evaluated with univariate and multivariate analysis, and factors influencing mortality were determined using Cox regression.Results Delirium occurred in 31.8% of 764 patients. Risk of delirium was independently associated with a history of hypertension (OR 1.88, 95% CI 1.3-2.6), alcoholism (2.03, 1.2-3.2), and severity of illness (1.25, 1.03-1.07 per 5-point increment in APACHE II score) but not with age or corticosteroid use. Sedatives and analgesics increased the risk of delirium when used to induce coma (OR 3.2, 95% CI 1.5-6.8), and not otherwise. Delirium was linked to longer ICU stay (11.5+/-11.5 vs. 4.4+/-3.9 days), longer hospital stay (18.2+/-15.7 vs. 13.2+/-19.4 days), higher ICU mortality (19.7% vs. 10.3%), and higher hospital mortality (26.7% vs. 21.4%).Conclusion Delirium is associated with a history of hypertension and alcoholism, higher APACHE II score, and with clinical effects of sedative and analgesic drugs.
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Delirium and agitation occur frequently in critically ill patients, with reported frequencies of 15% to 80%.
“Behavioral disorders such as delirium and agitation in the critically ill occur with a high frequency, ranging from 15% to 80% of patients, and have been associated with increased morbidity and risk of mortality [7-13].”
From Nicotine withdrawal and agitation in ventilated critically ill patients (2010) · cites this paper as [11]
Delirium and agitation in critically ill patients are associated with increased morbidity and risk of mortality.
“Behavioral disorders such as delirium and agitation in the critically ill occur with a high frequency, ranging from 15% to 80% of patients, and have been associated with increased morbidity and risk of mortality [7-13].”
From Nicotine withdrawal and agitation in ventilated critically ill patients (2010) · cites this paper as [11]
The incidence of delirium recorded in our study was 28%, at the low level of the range cited in the literature (13% to 70%).
“The 28% incidence of delirium we recorded at the low level of the wide range cited in the literature (13% to 70%) [8,11,38-40].”
From Nicotine withdrawal and agitation in ventilated critically ill patients (2010) · cites this paper as [11]
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- Authors
- Ouimet, S., Kavanagh, B. P., Gottfried, S. B., & Skrobik, Y.
- Affiliations
- Université de Montréal (CA)
- University of Toronto (CA)
- McGill University (CA)
- Hôpital Maisonneuve-Rosemont (CA)
- Corresponding author
- Skrobik, Yoanna
- ORCID
- Skrobik, Yoanna
- Venue
- Intensive Care Medicine
- Published
- 2006-11-11
- Volume
- 33
- Issue
- 1
- Pages
- 66-73
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W2138021422
- Cited by
- 972
- References
- 48
- Citations by year
- 2026: 20 · 2025: 21 · 2024: 29 · 2023: 53 · 2022: 54 · 2021: 50 · 2020: 55 · 2019: 47 · 2018: 63 · 2017: 67 · 2016: 58 · 2015: 52 · 2014: 55 · 2013: 76 · 2012: 72
- FWCI
- 31.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Keywords
- ICU delirium, delirium incidence, risk factors, hypertension, alcoholism, sedatives, analgesics, induced coma, ICU mortality, in-hospital mortality, ICU length of stay, length of hospital stay, critically ill patients
- MeSH terms
- Delirium, Female, Humans, Intensive Care Units, Male, Middle Aged, Prospective Studies, Risk Factors, Incidence
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