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

349 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

Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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  • Cite this

    Lin, S. M., Liu, C. Y., Wang, C. H., Lin, H. C., Huang, C. D., Huang, P. Y., Fang, Y. F., Shieh, M. H., & Kuo, H. P. (2004). The impact of delirium on the survival of mechanically ventilated patients. Critical Care Medicine, 32(11), 2254-2259. https://doi.org/10.1097/01.CCM.0000145587.16421.BB