Delirium in Intensive Care Patients –  a Prospective Study

Authors: M. Káňová 1–3;  M. Burda 4;  J. Povová 1;  J. Neiser 2,3
Authors‘ workplace: Ústav epidemiologie a ochrany veřejného zdraví, LF OU v Ostravě 1;  Klinika anesteziologie, resuscitace a intenzivní medicíny LF OU a FN Ostrava 2;  Katedra intenzivní medicíny a forenzních oborů, LF OU v Ostravě 3;  Centrum excelence IT4Innovations, Ústav pro výzkum a aplikace fuzzy modelování, OU v Ostravě 4
Published in: Cesk Slov Neurol N 2015; 78/111(6): 662-667
Category: Original Paper


Delirium, as a manifestation of acute brain dysfunction, is a frequent complication in critical care patients. Any critical disorder is an independent risk factor for development of delirium. The prevalence of delirium in critically ill patients has been reported between 11 and 87%. Delirium is under-diagnosed even though it significantly worsens patient prognosis. The aim of our study was to support regular use of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), in order to facilitate early diagnostics, prevention and treatment of delirium.

A prospective study of the incidence of delirium as well as risk factors for its development in patients admitted to six-bed ICU from February to June 2014. All patients were assessed for predisposing and precipitating risk factors using the Czech version of CAM-ICU. Fisher’s Exact Test and Wilcoxon Rank-Sum were performed with the significance level of 0.05.

Delirium was diagnosed in 125 of the overall group of 142 patients. Seventeen patients were excluded from the study as they could not be assessed (16 due to prolonged coma, one due to language barrier). The incidence of delirium reached 31.2%. Within the study group consisting of surgical, medical and trauma patients with the median APACHE II score of 12, medical and trauma patients were more likely to develop delirium than surgical ones. Development of delirium was associated with the severity of the disease (APACHE II score), use of sedatives, analgesics and vasopressors. Delirious patients stayed longer at the ICU and they showed higher need for artificial ventilation.

Key words:
delirium – diagnostic tests – intensive care units – predisposing risk factors – precipitating risk factors – prevention

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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