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

研究成果: 雜誌貢獻文章同行評審

377 引文 斯高帕斯(Scopus)

摘要

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.
原文英語
頁(從 - 到)2254-2259
頁數6
期刊Critical Care Medicine
32
發行號11
DOIs
出版狀態已發佈 - 11月 1 2004
對外發佈

ASJC Scopus subject areas

  • 重症監護和重症監護醫學

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