Cost Associated with Pediatric Delirium in the ICU
Open accessAbstract
OBJECTIVE: To determine the costs associated with delirium in critically ill children. DESIGN: Prospective observational study. SETTING: An urban, academic, tertiary-care PICU in New York city. PATIENTS: Four-hundred and sixty-four consecutive PICU admissions between September 2, 2014, and December 12, 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All children were assessed for delirium daily throughout their PICU stay. Hospital costs were analyzed using cost-to-charge ratios, in 2014 dollars. Median total PICU costs were higher in patients with delirium than in patients who were never delirious ($18,832 vs $4,803; p < 0.0001). Costs increased incrementally with number of days spent delirious (median cost of $9,173 for 1 d with delirium, $19,682 for 2-3 d with delirium, and $75,833 for > 3 d with delirium; p < 0.0001); this remained highly significant even after adjusting for PICU length of stay (p < 0.0001). After controlling for age, gender, severity of illness, and PICU length of stay, delirium was associated with an 85% increase in PICU costs (p < 0.0001). CONCLUSIONS: Pediatric delirium is associated with a major increase in PICU costs. Further research directed at prevention and treatment of pediatric delirium is essential to improve outcomes in this population and could lead to substantial healthcare savings.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Even after accounting for illness severity, delirium is associated with increased short- and long-term morbidity, leading to higher healthcare resource utilization and expenditure, and mortality.
“Even after accounting for illness severity, delirium is associated with increased short- and long-term morbidity, leading to higher healthcare resource utilization and expenditure, and mortality [7,61,64,65,66].”
From Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness (2022) · cites this paper as [65]
The Discussion reports that pediatric delirium was associated with higher PICU costs and resource use after controlling for illness severity and length of stay. The Introduction describes short- and long-term health effects, but the Limitations say consequences after discharge require further study. The paper does not establish the claimed link to mortality or show that morbidity causes the increased expenditure (page numbers unavailable). (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Barr, J., Fraser, G. L., Puntillo, K., Ely, E. W., Gélinas, C., Dasta, J. F., Davidson, J. E., Devlin, J. W., Kress, J. P., Joffe, A. M., et al. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182783b72 · Cited by 3,785 · see citing works
PIM2: a revised version of the Paediatric Index of Mortality
for the PIM Study Group, Slater, A., Shann, F. A., & Pearson, G. A. (2003) · Intensive Care Medicine · doi:10.1007/s00134-002-1601-2 · Cited by 1,068 · see citing works
Outcome of delirium in critically ill patients: systematic review and meta-analysis
Salluh, J. I., Wang, H., Schneider, E. B., Nagaraja, N., Yenokyan, G., Damluji, A. A., Serafim, R. B., & Stevens, R. D. (2015) · BMJ · doi:10.1136/bmj.h2538 · Cited by 1,057 · see citing works
The impact of delirium in the intensive care unit on hospital length of stay
Ely, E. W., Gautam, S., Margolin, R. A., Francis, J., May, L., Speroff, T., Truman, B., Dittus, R. S., Bernard, G. R., & Inouye, S. K. (2001) · Intensive Care Medicine · doi:10.1007/s00134-001-1132-2 · Cited by 1,032 · see citing works
Daily cost of an intensive care unit day: The contribution of mechanical ventilation*
Dasta, J. F., McLaughlin, T. P., Mody, S. H., & Piech, C. T. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000164543.14619.00 · Cited by 869 · see citing works
Costs associated with delirium in mechanically ventilated patients*
Milbrandt, E. B., Deppen, S. A., Harrison, P. L., Shintani, A., Speroff, T., Stiles, R. A., Truman, B., Bernard, G. R., Dittus, R. S., & Ely, E. W. (2004) · Critical Care Medicine · doi:10.1097/01.ccm.0000119429.16055.92 · Cited by 828 · see citing works
Cornell Assessment of Pediatric Delirium
Traube, C., Silver, G. H., Kearney, J. A., Patel, A. K., Atkinson, T. M., Yoon, M. J., Halpert, S., Augenstein, J. A., Sickles, L., Li, C., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182a66b76 · Cited by 536 · see citing works
Self-citationPrevalence, Risk Factors, and Outcomes of Delirium in Mechanically Ventilated Adults*
Mehta, S., Cook, D., Devlin, J. W., Skrobik, Y. K., Meade, M. O., Fergusson, D. A., Herridge, M. S., Steinberg, M., Granton, J. T., Ferguson, N. D., et al. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000727 · Cited by 347 · see citing works
Smith, H. A. B., Boyd, J., Fuchs, D. C., Melvin, K. E., Berry, P., Shintani, A., Eden, S., Terrell, M. K., Boswell, T., Wolfram, K. B., et al. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181feb489 · Cited by 334 · see citing works
Trogrlić, Z., van der Jagt, M., Bakker, J., Balas, M. C., Ely, E. W., van der Voort, P. H. J., & Ista, E. (2015) · Critical Care · doi:10.1186/s13054-015-0886-9 · Cited by 271 · see citing works
The Preschool Confusion Assessment Method for the ICU
Smith, H. A. B., Gangopadhyay, M., Goben, C. M., Jacobowski, N., Chestnut, M. H., Savage, S. W., Rutherford, M. T., Denton, D., Thompson, J. L., Chandrasekhar, R., et al. (2015) · Critical Care Medicine · doi:10.1097/ccm.0000000000001428 · Cited by 237 · see citing works
Kudchadkar, S. R., Yaster, M., & Punjabi, N. M. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000326 · Cited by 231 · see citing works
Preventing Delirium in the Intensive Care Unit
Brummel, N. E., & Girard, T. D. (2012) · Critical Care Clinics · doi:10.1016/j.ccc.2012.10.007 · Cited by 214 · see citing works
Wolters, A. E., van Dijk, D., Pasma, W., Cremer, O. L., Looije, M. F., de Lange, D. W., Veldhuijzen, D. S., & Slooter, A. J. C. (2014) · Critical Care · doi:10.1186/cc13929 · Cited by 200 · see citing works
Children's Factual and Delusional Memories of Intensive Care
Colville, G. A., Kerry, S., & Pierce, C. M. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200706-857oc · Cited by 193 · see citing works
Pediatric Delirium and Associated Risk Factors
Silver, G. H., Traube, C., Gerber, L. M., Sun, X., Kearney, J. A., Patel, A. K., & Greenwald, B. M. (2015) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000000356 · Cited by 191 · see citing works
Self-citationProlonged stay at the paediatric intensive care unit associated with paediatric delirium
Derks-Smeets, I. A. P., Tan, E. Y. L., Vossen, H. G. M., Leroy, P. L. J. M., Lousberg, R. L., van Os, J., & Schieveld, J. N. M. (2009) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-009-0063-2 · Cited by 92 · see citing works
The impact of adverse patient occurrences on hospital costs in the pediatric intensive care unit
Dominguez, T. E., Chalom, R., & Costarino, A. T. (2001) · Critical Care Medicine · doi:10.1097/00003246-200101000-00033 · Cited by 77 · see citing works
Nowak, J. E., Brilli, R. J., Lake, M. R., Sparling, K. W., Butcher, J., Schulte, M. E., & Wheeler, D. S. (2010) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0b013e3181d90569 · Cited by 77 · see citing works
Unplanned Extubations in Children
Roddy, D. J., Spaeder, M. C., Pastor, W., et al. (2015) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000000406 · Cited by 75 · see citing works
Delirium in the Pediatric Patient
Schieveld, J. N. M., & Janssen, N. J. J. F. (2014) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2014.125 · Cited by 59 · see citing works
Pediatric illness severity measures predict delirium in a pediatric intensive care unit
Schieveld, J. N. M., Lousberg, R. L., Berghmans, E., Derks-Smeets, I. A. P., Leroy, P. L. J. M., Vos, G. D., Nicolai, J., Leentjens, A. F. G., & van Os, J. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e31817cee5d · Cited by 56 · see citing works
Delirium Prevention and Treatment
Skrobik, Y. (2011) · Anesthesiology Clinics · doi:10.1016/j.anclin.2011.09.010 · Cited by 44 · see citing works
Schieveld, J. N. M., Tuijl, S. G. L. V., & Pikhard, T. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827bf658 · Cited by 20 · see citing works
Chang, B., Lorenzo, J., & Macario, A. (2015) · Anesthesiology Clinics · doi:10.1016/j.anclin.2015.07.012 · Cited by 14 · see citing works
Duration of Delirium and Patient-Centered Outcomes
Anderson, B. J., & Mikkelsen, M. E. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000265 · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Delirium and Mortality in Critically Ill Children: Epidemiology and Outcomes of Pediatric Delirium
Traube, C., Silver, G., Gerber, L. M., Kaur, S., Mauer, E. A., Kerson, A., Joyce, C., & Greenwald, B. M. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002324 · Cited by 379 · see citing works
Delirium is a Common and Early Finding in Patients in the Pediatric Cardiac Intensive Care Unit
Alvarez, R. V., Palmer, C., Czaja, A. S., Peyton, C., Silver, G., Traube, C., Mourani, P. M., & Kaufman, J. (2018) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2017.11.064 · Cited by 147 · see citing works
Self-citationDelirium in Pediatric Critical Care
Patel, A. K., Bell, M. J., & Traube, C. (2017) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2017.06.009 · Cited by 122 · see citing works
Self-citationPediatric Delirium: Evaluation, Management, and Special Considerations
Malas, N., Brahmbhatt, K., McDermott, C., Smith, A., Ortiz-Aguayo, R., & Turkel, S. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0817-3 · Cited by 67 · see citing works
Pediatric Delirium: Recognition, Management, and Outcome
Turkel, S. B. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0851-1 · Cited by 58 · see citing works
Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness
Nibras, S., Kentor, R., Masood, Y., Price, K., Schneider, N. M., Tenenbaum, R. B., & Calarge, C. (2022) · Children · doi:10.3390/children9071051 · Cited by 25 · see citing works
- Authors
- Traube, C., Mauer, E. A., Gerber, L. M., Kaur, S., Joyce, C., Kerson, A., Carlo, C., Notterman, D., Worgall, S., Silver, G., & Greenwald, B. M.
- Affiliations
- Weill Cornell Medicine (US)
- Princeton University (US)
- ORCID
- Venue
- Critical Care Medicine
- Published
- 2016-12
- Volume
- 44
- Issue
- 12
- Pages
- e1175-e1179
- ISSN
- 0090-3493 (ISSN-L)
- PMC
- PMC5592112
- OpenAlex
- W2514395058
- Cited by
- 181
- References
- 26
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 21 · 2023: 19 · 2022: 22 · 2021: 24 · 2020: 19 · 2019: 15 · 2018: 19 · 2017: 16 · 2016: 1 · 2014: 2
- FWCI
- 15.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000457)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD047879)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Keywords
- pediatric delirium, intensive care unit costs, pediatric intensive care unit, hospital costs, cost-to-charge ratio, critically ill children, length of hospital stay, health care costs
- MeSH terms
- Adolescent, Child, Child, Preschool, Delirium, Female, Humans, Infant, Infant, Newborn, Male, Prospective Studies, Intensive Care Units, Pediatric, Hospital Costs
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
