The impact of delirium on the survival of mechanically ventilated patients

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

Research output: Contribution to journalArticle

327 Citations (Scopus)

Abstract

Objectives: To revalidate a means of assessing delirium in intensive care unit patients and to investigate the independent effect of delirium on the mortality of mechanically ventilated patients. Design: A prospective cohort study. Setting: A 37-bed medical intensive care unit of a tertiary care hospital. Patients: Subjects were 102 of 131 consecutive mechanically ventilated patients. Measurements: All the enrolled patients were assessed for delirium using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Mortality rate were compared between patients with or without delirium, and the predictors of death were investigated. Results: The two CAM-ICU assessors' sensitivities in diagnosing delirium compared with reference standard were 91% and 95%, whereas their specificities were both 98%. They also demonstrated high interrater reliability with kappa statistics of 0.91. Delirium was present in 22 of 102 (22%) patients in the first 5 days. The delirious patients had higher intensive care unit mortality rate than nondelirious patients (63.6% vs. 32.5%, respectively), with a hazard ratio of 2.57 (95% confidence interval, 1.56-8.15). In multivariate analysis, delirium (odds ratio, 13.0; 95% confidence interval, 2.69-62.91), shock (odds ratio, 12.91; 95% confidence interval, 2.93-56.92), and illness severity (odds ratio, 9.61; 95% confidence interval, 2.24-41.18) were independent predictors of mortality. Conclusions: This study confirms previous work showing that delirium is an independent predictor for increased mortality among mechanically ventilated patients.

Original languageEnglish
Pages (from-to)2254-2259
Number of pages6
JournalCritical Care Medicine
Volume32
Issue number11
DOIs
Publication statusPublished - Nov 1 2004
Externally publishedYes

Fingerprint

Delirium
Survival
Intensive Care Units
Mortality
Confidence Intervals
Confusion
Odds Ratio
Tertiary Healthcare
Tertiary Care Centers
Shock
Cohort Studies
Multivariate Analysis
Prospective Studies

Keywords

  • Confusion Assessment Method for the Intensive Care Unit
  • Delirium
  • Mechanical ventilation
  • Respiratory failure

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

The impact of delirium on the survival of mechanically ventilated patients. / Lin, Shu Min; Liu, Chien Ying; Wang, Chun Hua; Lin, Horng Chyuan; Huang, Chien Da; Huang, Pei Yao; Fang, Yueh Fu; Shieh, Meng Heng; Kuo, Han Pin.

In: Critical Care Medicine, Vol. 32, No. 11, 01.11.2004, p. 2254-2259.

Research output: Contribution to journalArticle

Lin, SM, Liu, CY, Wang, CH, Lin, HC, Huang, CD, Huang, PY, Fang, YF, Shieh, MH & Kuo, HP 2004, 'The impact of delirium on the survival of mechanically ventilated patients', Critical Care Medicine, vol. 32, no. 11, pp. 2254-2259. https://doi.org/10.1097/01.CCM.0000145587.16421.BB
Lin, Shu Min ; Liu, Chien Ying ; Wang, Chun Hua ; Lin, Horng Chyuan ; Huang, Chien Da ; Huang, Pei Yao ; Fang, Yueh Fu ; Shieh, Meng Heng ; Kuo, Han Pin. / The impact of delirium on the survival of mechanically ventilated patients. In: Critical Care Medicine. 2004 ; Vol. 32, No. 11. pp. 2254-2259.
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AU - Liu, Chien Ying

AU - Wang, Chun Hua

AU - Lin, Horng Chyuan

AU - Huang, Chien Da

AU - Huang, Pei Yao

AU - Fang, Yueh Fu

AU - Shieh, Meng Heng

AU - Kuo, Han Pin

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N2 - Objectives: To revalidate a means of assessing delirium in intensive care unit patients and to investigate the independent effect of delirium on the mortality of mechanically ventilated patients. Design: A prospective cohort study. Setting: A 37-bed medical intensive care unit of a tertiary care hospital. Patients: Subjects were 102 of 131 consecutive mechanically ventilated patients. Measurements: All the enrolled patients were assessed for delirium using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Mortality rate were compared between patients with or without delirium, and the predictors of death were investigated. Results: The two CAM-ICU assessors' sensitivities in diagnosing delirium compared with reference standard were 91% and 95%, whereas their specificities were both 98%. They also demonstrated high interrater reliability with kappa statistics of 0.91. Delirium was present in 22 of 102 (22%) patients in the first 5 days. The delirious patients had higher intensive care unit mortality rate than nondelirious patients (63.6% vs. 32.5%, respectively), with a hazard ratio of 2.57 (95% confidence interval, 1.56-8.15). In multivariate analysis, delirium (odds ratio, 13.0; 95% confidence interval, 2.69-62.91), shock (odds ratio, 12.91; 95% confidence interval, 2.93-56.92), and illness severity (odds ratio, 9.61; 95% confidence interval, 2.24-41.18) were independent predictors of mortality. Conclusions: This study confirms previous work showing that delirium is an independent predictor for increased mortality among mechanically ventilated patients.

AB - Objectives: To revalidate a means of assessing delirium in intensive care unit patients and to investigate the independent effect of delirium on the mortality of mechanically ventilated patients. Design: A prospective cohort study. Setting: A 37-bed medical intensive care unit of a tertiary care hospital. Patients: Subjects were 102 of 131 consecutive mechanically ventilated patients. Measurements: All the enrolled patients were assessed for delirium using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Mortality rate were compared between patients with or without delirium, and the predictors of death were investigated. Results: The two CAM-ICU assessors' sensitivities in diagnosing delirium compared with reference standard were 91% and 95%, whereas their specificities were both 98%. They also demonstrated high interrater reliability with kappa statistics of 0.91. Delirium was present in 22 of 102 (22%) patients in the first 5 days. The delirious patients had higher intensive care unit mortality rate than nondelirious patients (63.6% vs. 32.5%, respectively), with a hazard ratio of 2.57 (95% confidence interval, 1.56-8.15). In multivariate analysis, delirium (odds ratio, 13.0; 95% confidence interval, 2.69-62.91), shock (odds ratio, 12.91; 95% confidence interval, 2.93-56.92), and illness severity (odds ratio, 9.61; 95% confidence interval, 2.24-41.18) were independent predictors of mortality. Conclusions: This study confirms previous work showing that delirium is an independent predictor for increased mortality among mechanically ventilated patients.

KW - Confusion Assessment Method for the Intensive Care Unit

KW - Delirium

KW - Mechanical ventilation

KW - Respiratory failure

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