The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients
Abstract
OBJECTIVE: Previously, delirium has been identified as an independent risk factor for mortality in critically ill medical patients. We undertook this study to examine the relationships among medication usage, delirium, and clinical outcomes in a critically ill surgical/trauma population. DESIGN: Prospective, multicentered, observational study. SETTING: Two surgical intensive care units in level 1 trauma centers. PATIENTS: One hundred thirty-four consecutive surgical adult patients requiring mechanical ventilation (MV) for greater than 24 hours. INTERVENTIONS: Daily delirium assessment with the Confusion Assessment Method-Intensive Care Unit tool, outcomes assessment, and prospective data collection. MEASUREMENT AND MAIN RESULTS: Of the 134 patients who met inclusion criteria, 84 patients (63%) developed delirium at some point during their intensive care unit (ICU) stay. Delirium was associated with more MV days (9.1 vs. 4.9 days, p < 0.01), longer ICU stay (12.2 vs. 7.4 days, p < 0.01), longer hospital stay (20.6 vs. 14.7 days, p < 0.01). Additionally, greater cumulative lorazepam dose (p = 0.012), and higher cumulative fentanyl dose (p = 0.035) were administered in the delirium group. CONCLUSIONS: Delirium in the surgical/trauma ICU cohort is independently associated with more days requiring MV, longer ICU length of stay, and longer hospital length of stay. Additionally, greater amounts of lorazepam and fentanyl were administered to patients with delirium.
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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 [39]
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- Authors
- Lat, I., McMillian, W., Taylor, S., Janzen, J. M., Papadopoulos, S., Korth, L., Ehtisham, A., Nold, J., Agarwal, S., Azocar, R., & Burke, P.
- Affiliations
- University of Chicago (US)
- Boston Medical Center (US)
- Venue
- Critical Care Medicine
- Published
- 2009-06
- Volume
- 37
- Issue
- 6
- Pages
- 1898-1905
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2022831518
- Cited by
- 222
- References
- 18
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 10 · 2023: 7 · 2022: 9 · 2021: 12 · 2020: 17 · 2019: 11 · 2018: 19 · 2017: 16 · 2016: 16 · 2015: 17 · 2014: 18 · 2013: 20 · 2012: 19
- FWCI
- 10.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Keywords
- delirium, mechanical ventilation, surgical patients, trauma patients, intensive care unit, length of hospital stay, lorazepam, fentanyl, medication use, postoperative delirium
- MeSH terms
- Adult, Aged, Delirium, Female, Humans, Male, Middle Aged, Postoperative Complications, Prospective Studies, Respiration, Artificial, Risk Factors, Wounds and Injuries, Incidence, Critical Illness
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