Time trends of delirium rates in the intensive care unit

Sikandar H. Khan; Heidi Lindroth; Kyle Hendrie; Sophia Wang; Sundus Imran; Anthony J. Perkins; Sujuan Gao; Farhaan S. Vahidy; Malaz Boustani; Babar A. Khan

doi:10.1016/j.hrtlng.2020.03.006

Time trends of delirium rates in the intensive care unit

Sikandar H. Khan, Heidi Lindroth, Kyle Hendrie, Sophia Wang, Sundus Imran, Anthony J. Perkins, Sujuan Gao, Farhaan S. Vahidy, Malaz Boustani, Babar A. Khan

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Background: Effects of clinical practice changes on ICU delirium are not well understood. Objectives: Determine ICU delirium rates over time. Methods: Data from a previously described screening cohort of the Pharmacological Management of Delirium trial was analyzed. Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method for the ICU (CAM-ICU) were assessed twice daily. We defined: Any delirium (positive CAM-ICU at any time during ICU stay) and ICU-acquired delirium (1st CAM-ICU negative with a subsequent positive CAM-ICU). Mixed-effects logistic regression models were used to test for differences. Results: 2742 patient admissions were included. Delirium occurred in 16.5%, any delirium decreased [22.7% to 10.2% (p < 0.01)], and ICU-acquired delirium decreased [8.4% to 4.4% (p = 0.01)]. Coma decreased from 24% to 17.4% (p = 0.04). Later ICU years and higher mean RASS scores were associated with lower odds of delirium. Conclusions: Delirium rates were not explained by the measured variables and further prospective research is needed.

Original language	English (US)
Pages (from-to)	572-577
Number of pages	6
Journal	Heart and Lung
Volume	49
Issue number	5
DOIs	https://doi.org/10.1016/j.hrtlng.2020.03.006
State	Published - Sep 1 2020

Keywords

Delirium
Intensive care unit
Outcomes
Time trend

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1016/j.hrtlng.2020.03.006

Cite this

@article{7a4841e78ba448adaf52993a1a8be965,

title = "Time trends of delirium rates in the intensive care unit",

abstract = "Background: Effects of clinical practice changes on ICU delirium are not well understood. Objectives: Determine ICU delirium rates over time. Methods: Data from a previously described screening cohort of the Pharmacological Management of Delirium trial was analyzed. Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method for the ICU (CAM-ICU) were assessed twice daily. We defined: Any delirium (positive CAM-ICU at any time during ICU stay) and ICU-acquired delirium (1st CAM-ICU negative with a subsequent positive CAM-ICU). Mixed-effects logistic regression models were used to test for differences. Results: 2742 patient admissions were included. Delirium occurred in 16.5%, any delirium decreased [22.7% to 10.2% (p < 0.01)], and ICU-acquired delirium decreased [8.4% to 4.4% (p = 0.01)]. Coma decreased from 24% to 17.4% (p = 0.04). Later ICU years and higher mean RASS scores were associated with lower odds of delirium. Conclusions: Delirium rates were not explained by the measured variables and further prospective research is needed.",

keywords = "Delirium, Intensive care unit, Outcomes, Time trend",

author = "Khan, {Sikandar H.} and Heidi Lindroth and Kyle Hendrie and Sophia Wang and Sundus Imran and Perkins, {Anthony J.} and Sujuan Gao and Vahidy, {Farhaan S.} and Malaz Boustani and Khan, {Babar A.}",

note = "Funding Information: MB is supported by NIA R01AG052493 . BK is supported by NIA R01AG055391 , R01HL131730 . S.W. is funded by K23AG062555-01 and NIA 2P30AG010133 . Funding Information: We thank members of the Team Vitality Research Core and the patients and care providers who made this work possible. MB is supported by NIA R01AG052493. BK is supported by NIA R01AG055391, R01HL131730. S.W. is funded by K23AG062555-01 and NIA 2P30AG010133. Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

year = "2020",

month = sep,

day = "1",

doi = "10.1016/j.hrtlng.2020.03.006",

language = "English (US)",

volume = "49",

pages = "572--577",

journal = "Heart and Lung",

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number = "5",

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TY - JOUR

T1 - Time trends of delirium rates in the intensive care unit

AU - Khan, Sikandar H.

AU - Lindroth, Heidi

AU - Hendrie, Kyle

AU - Wang, Sophia

AU - Imran, Sundus

AU - Perkins, Anthony J.

AU - Gao, Sujuan

AU - Vahidy, Farhaan S.

AU - Boustani, Malaz

AU - Khan, Babar A.

N1 - Funding Information: MB is supported by NIA R01AG052493 . BK is supported by NIA R01AG055391 , R01HL131730 . S.W. is funded by K23AG062555-01 and NIA 2P30AG010133 . Funding Information: We thank members of the Team Vitality Research Core and the patients and care providers who made this work possible. MB is supported by NIA R01AG052493. BK is supported by NIA R01AG055391, R01HL131730. S.W. is funded by K23AG062555-01 and NIA 2P30AG010133. Publisher Copyright: © 2020 Elsevier Inc.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background: Effects of clinical practice changes on ICU delirium are not well understood. Objectives: Determine ICU delirium rates over time. Methods: Data from a previously described screening cohort of the Pharmacological Management of Delirium trial was analyzed. Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method for the ICU (CAM-ICU) were assessed twice daily. We defined: Any delirium (positive CAM-ICU at any time during ICU stay) and ICU-acquired delirium (1st CAM-ICU negative with a subsequent positive CAM-ICU). Mixed-effects logistic regression models were used to test for differences. Results: 2742 patient admissions were included. Delirium occurred in 16.5%, any delirium decreased [22.7% to 10.2% (p < 0.01)], and ICU-acquired delirium decreased [8.4% to 4.4% (p = 0.01)]. Coma decreased from 24% to 17.4% (p = 0.04). Later ICU years and higher mean RASS scores were associated with lower odds of delirium. Conclusions: Delirium rates were not explained by the measured variables and further prospective research is needed.

AB - Background: Effects of clinical practice changes on ICU delirium are not well understood. Objectives: Determine ICU delirium rates over time. Methods: Data from a previously described screening cohort of the Pharmacological Management of Delirium trial was analyzed. Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method for the ICU (CAM-ICU) were assessed twice daily. We defined: Any delirium (positive CAM-ICU at any time during ICU stay) and ICU-acquired delirium (1st CAM-ICU negative with a subsequent positive CAM-ICU). Mixed-effects logistic regression models were used to test for differences. Results: 2742 patient admissions were included. Delirium occurred in 16.5%, any delirium decreased [22.7% to 10.2% (p < 0.01)], and ICU-acquired delirium decreased [8.4% to 4.4% (p = 0.01)]. Coma decreased from 24% to 17.4% (p = 0.04). Later ICU years and higher mean RASS scores were associated with lower odds of delirium. Conclusions: Delirium rates were not explained by the measured variables and further prospective research is needed.

KW - Delirium

KW - Intensive care unit

KW - Outcomes

KW - Time trend

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U2 - 10.1016/j.hrtlng.2020.03.006

DO - 10.1016/j.hrtlng.2020.03.006

M3 - Article

C2 - 32220395

AN - SCOPUS:85082482763

SN - 0147-9563

VL - 49

SP - 572

EP - 577

JO - Heart and Lung

JF - Heart and Lung

IS - 5

ER -

Time trends of delirium rates in the intensive care unit

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Keywords

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