Evaluation of Delirium Risk Factors in Intensive Care Patients.

Selin Erel, Eda Macit Aydın, Bijen Nazlıel, Lale Karabıyık
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Abstract

Objective: The negative effects of delirium in intensive care unit (ICU) patients necessitate the identification and management of risk factors. This study aimed to determine the incidence of delirium and its associated modifiable and non-modifiable factors in the ICU setting to provide valuable insights for better patient care and outcomes.

Methods: Patients admitted to the ICU underwent delirium screening twice daily. Comprehensive records of modifiable and non-modifiable risk factors were maintained throughout the ICU stay.

Results: The incidence of delirium was 32.5%. Age [odds ratio (OR) 1.04, confidence interval (CI) 1.02-1.06, P < 0.001)]. Illiteracy (OR 4, CI 1.19-13.35, P=0.02), hearing impairment (OR 3.37, CI 1.71-7.01, P=0.001), visual impairment (OR 3.90, CI 2.13-7.15, P < 0.001), hypertension (OR 2.56, CI 1.42-4.62, P=0.002), Sequential Organ Failure Assessment score (OR 1.21, CI 1.08-1.36, P=0.001), Acute Physiology and Chronic Health Evaluation II score (OR 1.20, CI 1.12-1.28, P < 0.001), presence of a nasogastric catheter/drain (OR 2.15, CI 1.18-3. 90, P=0.01), tracheal aspiration (OR 3.63, CI 1.91-6.90, P < 0.001), enteral nutrition (OR 2.54, CI 1.12-5.76, P=0.02), constipation (OR 1.65, Cl 1.11-2.45, P=0.02), oliguria (OR 1.56, Cl 1.06-2.28, P=0.02), midazolam infusion (OR 3. 4, Cl 1.16-10.05, P=0.02), propofol infusion (OR 2.91 Cl 1.03-8.19, P=0.04), albumin use (OR 2.39, Cl 1.11-5.14 P=0.02) and steroid use (OR 2.17, Cl 1.06-4.40, P=0.03) were found to be independent risk factors for delirium.

Conclusion: This study highlights several risk factors contributing to delirium, such as age, sensory impairment, educational level, procedural interventions, and medications. Oral nutrition and mobilization are effective strategies for reducing delirium incidence in the ICU.

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重症监护患者谵妄危险因素的评价。
目的:重症监护病房(ICU)患者谵妄的负面影响需要识别和管理危险因素。本研究旨在确定谵妄的发生率及其相关的可改变和不可改变的因素,为更好的患者护理和结果提供有价值的见解。方法:ICU住院患者每日进行两次谵妄筛查。在整个ICU住院期间保持可改变和不可改变的危险因素的综合记录。结果:谵妄发生率为32.5%。年龄[优势比(OR) 1.04,可信区间(CI) 1.02-1.06, P < 0.001)]。文盲(OR 4, CI 1.19-13.35, P=0.02)、听力障碍(OR 3.37, CI 1.71-7.01, P=0.001)、视力障碍(OR 3.90, CI 2.13-7.15, P < 0.001)、高血压(OR 2.56, CI 1.42-4.62, P=0.002)、序贯器官衰竭评估评分(OR 1.21, CI 1.08-1.36, P=0.001)、急性生理和慢性健康评估II评分(OR 1.20, CI 1.12-1.28, P < 0.001)、存在鼻胃导管/引流管(OR 2.15, CI 1.18-3)。90, P=0.01)、气管抽吸(OR 3.63, CI 1.91 ~ 6.90, P < 0.001)、肠内营养(OR 2.54, CI 1.12 ~ 5.76, P=0.02)、便秘(OR 1.65, Cl 1.11 ~ 2.45, P=0.02)、少尿(OR 1.56, Cl 1.06 ~ 2.28, P=0.02)、咪达唑仑输注(OR 3。4, Cl 1.16-10.05, P=0.02)、异丙酚输注(OR 2.91 Cl 1.03-8.19, P=0.04)、白蛋白使用(OR 2.39, Cl 1.11-5.14, P=0.02)和类固醇使用(OR 2.17, Cl 1.06-4.40, P=0.03)是谵妄的独立危险因素。结论:本研究强调了谵妄的几个危险因素,如年龄、感觉障碍、教育水平、程序干预和药物。口服营养和运动是减少重症监护病房谵妄发生率的有效策略。
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