Patterns of Postoperative Delirium in Children
Abstract
OBJECTIVE: Intensive care delirium is a substantial problem in adults. Intensive care delirium is increasingly recognized in pediatrics in parallel with the development of specific scoring systems for children. However, little is known about the fluctuating course of intensive care delirium in children after surgery and possible implications on diagnostic and therapeutic strategies. DESIGN: Patients that needed treatment in the PICU following elective surgery were screened for intensive care delirium with the Cornell Assessment of Pediatric Delirium. When the patients were awake (Richmond Agitation and Sedation Score > -3), two trained investigators conducted the Cornell Assessment of Pediatric Delirium twice daily for five consecutive days. PATIENTS: Ninety-three patients aged 0 to 17 years. INTERVENTIONS: Eight hundred forty-five assessments completed. MEASUREMENTS AND MAIN RESULTS: Of the 845 scores, 230 were consistent with delirium (27.2%). Sixty-one patients (65.5%) were diagnosed with intensive care delirium. Half of these patients (n = 30; 32.2%) had a short-lasting delirium that resolved within 24 hours, and half (n = 31; 33.3%) had delirium of longer duration. Delirium could be clearly distinguished from sedation by analysis of individual test items of the Cornell Assessment of Pediatric Delirium. Time spent delirious had a measurable effect on outcome variables, including hospital length of stay. CONCLUSION: Most postoperative PICU patients develop intensive care delirium. Some have a short-lasting course, which underlines the need for early screening. Our findings support the view of delirium as a continuum of acute neurocognitive disorder. Further research is needed to investigate prophylactic and treatment approaches for intensive care delirium.
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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 [64]
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- Authors
- Meyburg, J., Dill, M.-L., Traube, C., Silver, G., & von Haken, R.
- Affiliations
- Heidelberg University (DE)
- Weill Cornell Medicine (US)
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany.
- Venue
- Pediatric Critical Care Medicine
- Published
- 2017-02
- Volume
- 18
- Issue
- 2
- Pages
- 128-133
- ISSN
- 1529-7535 (ISSN-L)
- OpenAlex
- W2534753482
- Cited by
- 100
- References
- 25
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 8 · 2023: 14 · 2022: 15 · 2021: 11 · 2020: 15 · 2019: 9 · 2018: 10 · 2017: 7
- FWCI
- 7.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pediatric Critical 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 › Epidemiology › Traumatic Brain Injury Research
- Keywords
- postoperative delirium, pediatric intensive care, elective surgery, Cornell Assessment of Pediatric Delirium, delirium duration, sedation, length of hospital stay, neurocognitive disorders, early screening
- MeSH terms
- Adolescent, Child, Child, Preschool, Critical Care, Delirium, Female, Humans, Infant, Infant, Newborn, Male, Postoperative Complications, Prognosis, Intensive Care Units, Pediatric, Disease Progression
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