Risk factors for the development of early-onset delirium and the subsequent clinical outcome in mechanically ventilated patients

Shu Min Lin, Chien Da Huang, Chien Ying Liu, Horng Chyuan Lin, Chun Hua Wang, Pei Yao Huang, Yueh Fu Fang, Meng Heng Shieh, Han Pin Kuo

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Objectives: The aim of the study was to investigate the risk factors of developing early-onset delirium in mechanically ventilated patients and determine the subsequent clinical outcomes. Methods: Confusion assessment method for the intensive care unit (ICU) was used to assess the enrolled mechanically ventilated patients for delirium. The risk factors of developing delirium and clinical outcomes were determined in these subjects. Results: Delirium was present in 31 (21.7%) of 143 patients in the first 5 days. In multivariable analysis, hypoalbuminemia (odds ratio, 5.94; 95% confidence interval, 1.23-28.77) and sepsis (odds ratio, 3.65; 95% confidence interval, 1.03-12.9) increased the risk of developing delirium in mechanically ventilated patients. The patients with delirium had a higher in-hospital mortality (67.7% vs 33.9%, respectively; P = .001) and longer duration of mechanical ventilation (19.5 ± 15.8 vs 9.3 ± 8.8 days, respectively; P = .003) than patients without delirium. The incidence of nosocomial pneumonia was increased in delirious patients (64.5% vs 38.4%, P = .01) compared with nondelirious patients, whereas the lengths of ICU or hospital stay were similar between both groups. Conclusions: Mechanically ventilated patients with sepsis or hypoalbuminemia were more vulnerable to develop delirium in their early stay in the ICU. Early-onset delirium is associated with prolonged duration of mechanical ventilation and higher incidence of nosocomial pneumonia, leading to a higher mortality.

Original languageEnglish
Pages (from-to)372-379
Number of pages8
JournalJournal of Critical Care
Volume23
Issue number3
DOIs
Publication statusPublished - Sep 1 2008
Externally publishedYes

Fingerprint

Delirium
Intensive Care Units
Hypoalbuminemia
Artificial Respiration
Sepsis
Pneumonia
Odds Ratio
Confidence Intervals
Confusion
Incidence
Hospital Mortality
Length of Stay
Mortality

Keywords

  • Albumin
  • Delirium
  • Mortality
  • Risk factors
  • Sepsis
  • Ventilator

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Risk factors for the development of early-onset delirium and the subsequent clinical outcome in mechanically ventilated patients. / Lin, Shu Min; Huang, Chien Da; Liu, Chien Ying; Lin, Horng Chyuan; Wang, Chun Hua; Huang, Pei Yao; Fang, Yueh Fu; Shieh, Meng Heng; Kuo, Han Pin.

In: Journal of Critical Care, Vol. 23, No. 3, 01.09.2008, p. 372-379.

Research output: Contribution to journalArticle

Lin, Shu Min ; Huang, Chien Da ; Liu, Chien Ying ; Lin, Horng Chyuan ; Wang, Chun Hua ; Huang, Pei Yao ; Fang, Yueh Fu ; Shieh, Meng Heng ; Kuo, Han Pin. / Risk factors for the development of early-onset delirium and the subsequent clinical outcome in mechanically ventilated patients. In: Journal of Critical Care. 2008 ; Vol. 23, No. 3. pp. 372-379.
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abstract = "Objectives: The aim of the study was to investigate the risk factors of developing early-onset delirium in mechanically ventilated patients and determine the subsequent clinical outcomes. Methods: Confusion assessment method for the intensive care unit (ICU) was used to assess the enrolled mechanically ventilated patients for delirium. The risk factors of developing delirium and clinical outcomes were determined in these subjects. Results: Delirium was present in 31 (21.7{\%}) of 143 patients in the first 5 days. In multivariable analysis, hypoalbuminemia (odds ratio, 5.94; 95{\%} confidence interval, 1.23-28.77) and sepsis (odds ratio, 3.65; 95{\%} confidence interval, 1.03-12.9) increased the risk of developing delirium in mechanically ventilated patients. The patients with delirium had a higher in-hospital mortality (67.7{\%} vs 33.9{\%}, respectively; P = .001) and longer duration of mechanical ventilation (19.5 ± 15.8 vs 9.3 ± 8.8 days, respectively; P = .003) than patients without delirium. The incidence of nosocomial pneumonia was increased in delirious patients (64.5{\%} vs 38.4{\%}, P = .01) compared with nondelirious patients, whereas the lengths of ICU or hospital stay were similar between both groups. Conclusions: Mechanically ventilated patients with sepsis or hypoalbuminemia were more vulnerable to develop delirium in their early stay in the ICU. Early-onset delirium is associated with prolonged duration of mechanical ventilation and higher incidence of nosocomial pneumonia, leading to a higher mortality.",
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AU - Huang, Chien Da

AU - Liu, Chien Ying

AU - Lin, Horng Chyuan

AU - Wang, Chun Hua

AU - Huang, Pei Yao

AU - Fang, Yueh Fu

AU - Shieh, Meng Heng

AU - Kuo, Han Pin

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N2 - Objectives: The aim of the study was to investigate the risk factors of developing early-onset delirium in mechanically ventilated patients and determine the subsequent clinical outcomes. Methods: Confusion assessment method for the intensive care unit (ICU) was used to assess the enrolled mechanically ventilated patients for delirium. The risk factors of developing delirium and clinical outcomes were determined in these subjects. Results: Delirium was present in 31 (21.7%) of 143 patients in the first 5 days. In multivariable analysis, hypoalbuminemia (odds ratio, 5.94; 95% confidence interval, 1.23-28.77) and sepsis (odds ratio, 3.65; 95% confidence interval, 1.03-12.9) increased the risk of developing delirium in mechanically ventilated patients. The patients with delirium had a higher in-hospital mortality (67.7% vs 33.9%, respectively; P = .001) and longer duration of mechanical ventilation (19.5 ± 15.8 vs 9.3 ± 8.8 days, respectively; P = .003) than patients without delirium. The incidence of nosocomial pneumonia was increased in delirious patients (64.5% vs 38.4%, P = .01) compared with nondelirious patients, whereas the lengths of ICU or hospital stay were similar between both groups. Conclusions: Mechanically ventilated patients with sepsis or hypoalbuminemia were more vulnerable to develop delirium in their early stay in the ICU. Early-onset delirium is associated with prolonged duration of mechanical ventilation and higher incidence of nosocomial pneumonia, leading to a higher mortality.

AB - Objectives: The aim of the study was to investigate the risk factors of developing early-onset delirium in mechanically ventilated patients and determine the subsequent clinical outcomes. Methods: Confusion assessment method for the intensive care unit (ICU) was used to assess the enrolled mechanically ventilated patients for delirium. The risk factors of developing delirium and clinical outcomes were determined in these subjects. Results: Delirium was present in 31 (21.7%) of 143 patients in the first 5 days. In multivariable analysis, hypoalbuminemia (odds ratio, 5.94; 95% confidence interval, 1.23-28.77) and sepsis (odds ratio, 3.65; 95% confidence interval, 1.03-12.9) increased the risk of developing delirium in mechanically ventilated patients. The patients with delirium had a higher in-hospital mortality (67.7% vs 33.9%, respectively; P = .001) and longer duration of mechanical ventilation (19.5 ± 15.8 vs 9.3 ± 8.8 days, respectively; P = .003) than patients without delirium. The incidence of nosocomial pneumonia was increased in delirious patients (64.5% vs 38.4%, P = .01) compared with nondelirious patients, whereas the lengths of ICU or hospital stay were similar between both groups. Conclusions: Mechanically ventilated patients with sepsis or hypoalbuminemia were more vulnerable to develop delirium in their early stay in the ICU. Early-onset delirium is associated with prolonged duration of mechanical ventilation and higher incidence of nosocomial pneumonia, leading to a higher mortality.

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KW - Mortality

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KW - Sepsis

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