Delirium in the ICU Linked to Fatal Outcomes
Although intensive care teams have long been aware that a significant percentage of their patients develop delirium, this study establishes the most definitive link between delirium in the ICU and poor outcomes.
“Every patient who develops delirium will on average remain in the hospital at least one day longer,” says one of the study's authors Dr. Robert Stevens, a specialist in critical care and an associate professor at the Johns Hopkins University School of Medicine. Worse, “if you're admitted to the intensive care unit and you develop brain dysfunction, your risk of not surviving your hospital stay is doubled.”
Dr. Stevens and colleagues performed a systematic review and meta-analysis of available data on delirium in ICU patients. They sifted through 10,000 published reports before selecting 42 studies that met their specific criteria. They excluded studies that primarily enrolled patients with head injuries, strokes or other neurological disorders, or focused on sedation management or alcohol or substance withdrawal.
Delirium was identified in 5,280 of 16,595 (31.8 percent) critically ill patients reported in the 42 studies included in the meta-analysis. Dr. Stevens and his team found that delirium was associated with a twofold increase in hospital mortality even after adjusting for severity of illness.
Delirium is a type of brain dysfunction characterised by a sudden onset, fluctuating symptoms, inattention and confusion. One of the best known causes of delirium is medications given to ICU patients, such as sedatives. For example, benzodiazepine, which is commonly administered to patients to help them calm down and sleep, may ironically lead to disorientation and confusion. The use of such potentially harmful medications, particularly among higher risk populations (eg, the elderly and individuals with dementia), should be reduced or eliminated, the researchers say, adding that nighttime interruptions should also be minimised to ensure that patients get a good night’s rest without sedatives.
Notably, Dr. Stevens’ review also showed that among patients who develop delirium, the risk of long-term cognitive decline increases by 20 to 30 percent. “We’re seeing that even though you may have a very severe illness or injury and you’re lucky enough to survive, you’re still not quite out of the woods,” he says. “We need to think about the measures we can put into place to decrease these long-term burdens.”
Source: Johns Hopkins Medicine
Image credit: Flickr.com
Published on : Mon, 8 Jun 2015
Print as PDF
17 critical parameters from a blood sample as small as 45 µL Not available in the US When the sample is small but your diagnostic needs are big, the ABL90 FLEX PLUS blood gas analyzer provides critical insights with a turnaround time of less than...
NovaPort cannulas: The safe access to the vascular system. NovaPort® twin double lumen cannulas are specifically developed for veno-venous vascular access. NovaPort one single lumen cannulas are specifically developed for the percutaneous connection (KU)...
Monitor vital signs of sensitive patients with reliable, smart and intuitive technology Not available in the US Sensitive patients, like neonates, require comfortable care. With transcutaneous monitoring, you can easily keep track of the oxygenation...
Get an complete overview of your POCT setup - from one dashboard Your point-of-care-testing setup probably involves many different types of devices from various manufacturers. Radiometer's AQURE point-of-care management system can give you an overview...