scholarly journals The Relationship Between Delirium and Statin Use According To Disease Severity in Patients in the Intensive Care Unit

2021 ◽  
Author(s):  
Jun Yong An ◽  
Jin Young Park ◽  
Jaehwa Cho ◽  
Hesun Erin Kim ◽  
Jaesub Park ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disease Severity ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Large Cohort ◽  
Severance Hospital ◽  
Severe Group ◽  
Group 2 ◽  
Statin Use

Abstract Background There have been few earlier studies on the efficacy of statins in the prevention of delirium. However, the results were controversial. The aim of this study was to investigate the association between the use of statins and the occurrence of delirium in a large cohort of patients in the intensive care unit (ICU), considering disease severity and statin properties, which were not sufficiently considered in the previous works. Methods We obtained clinical and demographical information from 3604 patients admitted to the ICU of Gangnam Severance Hospital from January 2013 to April 2020. This included information on daily statin use and delirium state, as assessed by the Confusion Assessment Method for ICU. We used inverse probability of treatment weighting and categorized the ICU patients into four groups based on the Acute Physiology and Chronic Health Evaluation II score (group 1: 0-10 - mild; group 2: 11-20 – mild to moderate; group 3: 21-30 – moderate to severe; group 4: > 30 - severe). We analyzed the association between the use of statin and the occurrence of delirium in each group, while taking into account the properties of statins. Results Comparisons between statin and non-statin patient groups revealed that only in group 2, patients who were administered statin showed significantly higher occurrence of delirium (p=0.004, odds ratio [OR]=1.58) compared to the patients who did not receive statin. Regardless of whether statins were lipophilic (p=0.036, OR=1.47) or hydrophilic (p=0.032, OR=1.84), the occurrence of delirium was higher only in patients from group 2. Although both lipophilic and hydrophilic statins in group 2 were associated with delirium, neither showed a greater association than the other. Conclusions The use of statins may be associated with the increases in the risk of delirium occurrence in patients with mild to moderate disease severity, irrespective of statin properties, as revealed by results from a large cohort study.

scholarly journals Postoperative delirium after cardiac surgery of elderly patients as an independent risk factor for prolonged length of stay in intensive care unit and in hospital

2021 ◽  
Author(s):  
Andrea Kirfel ◽  
Jan Menzenbach ◽  
Vera Guttenthaler ◽  
Johanna Feggeler ◽  
Andreas Mayr ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Hospital Length Of Stay ◽  
Confusion Assessment

Abstract Background Postoperative delirium (POD) is a relevant and underdiagnosed complication after cardiac surgery that is associated with increased intensive care unit (ICU) and hospital length of stay (LOS). The aim of this subgroup study was to compare the frequency of tested POD versus the coded International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis of POD and to evaluate the influence of POD on LOS in ICU and hospital. Methods 254 elective cardiac surgery patients (mean age, 70.5 ± 6.4 years) at the University Hospital Bonn between September 2018 and October 2019 were evaluated. The endpoint tested POD was considered positive, if one of the tests Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method (CAM), 4 'A's Test (4AT) or Delirium Observation Scale (DOS) was positive on one day. Results POD occurred in 127 patients (50.0%). LOS in ICU and hospital were significantly different based on presence (ICU 165.0 ± 362.7 h; Hospital 26.5 ± 26.1 days) or absence (ICU 64.5 ± 79.4 h; Hospital 14.6 ± 6.7 days) of POD (p < 0.001). The multiple linear regression showed POD as an independent predictor for a prolonged LOS in ICU (48%; 95%CI 31–67%) and in hospital (64%; 95%CI 27–110%) (p < 0.001). The frequency of POD in the study participants that was coded with the ICD F05.0 and F05.8 by hospital staff was considerably lower than tests revealed by the study personnel. Conclusion Approximately 50% of elderly patients who underwent cardiac surgery developed POD, which is associated with an increased ICU and hospital LOS. Furthermore, POD is highly underdiagnosed in clinical routine.

Confusion Assessment Method for the Intensive Care Unit

2001 ◽  
Author(s):  
E. Wesley Ely ◽  
Sharon K. Inouye ◽  
Gordon R. Bernard ◽  
Joseph Francis ◽  
Lisa May ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Confusion Assessment

scholarly journals Assessment of delirium in children admitted into the Intensive Care Unit: psCAM-ICU Tool

2020 ◽  
Vol 38 (2) ◽  
pp. 140-148
Author(s):  
Ángela María Henao Castaño ◽  
Edwar Yamith Pinzon Casas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Primary Diagnosis ◽  
Critically Ill Children ◽  
Associated Risk Factors ◽  
Prolonged Hospital

Background: Delirium has been identified as a risk factor for the mortality of critically ill patients, generating great social and economic impacts, since patients require more days of mechanical ventilation and a prolonged hospital stay in the intensive care unit (ICU), thus increasing medical costs. Objective: To describe the prevalence and characteristics of delirium episodes in a sample of 6-month to 5-year-old children who are critically ill. Methods: Cohort study at a Pediatric Intensive Care Unit (PICU) in Bogotá (Colombia). Participants were assessed by the Preschool Confusion Assessment Method for the ICU (psCAM-ICU) within the first twenty-four hours of hospitalization. Results: One quarter of the participants (25.8%) presented some type of delirium. Among them, two sub-types of delirium were observed: 62.5% of the cases were hypoactive and 37.5% hyperactive. Moreover, from them, six were male (75%) and 2 female (25%). Primary diagnosis was respiratory tract infection in 62.55% of the patients, while respiratory failure was diagnosed in the remaining 37.5%. Conclusions: The implementation of delirium monitoring tools in critically ill children provides a better understanding of the clinical manifestation of this phenomenon and associated risk factors in order to contribute to the design of efficient intervention strategies.

Serum protein S100 as marker of postoperative delirium after off-pump coronary artery bypass surgery: secondary analysis of two prospective randomized controlled trials

2016 ◽  
Vol 54 (10) ◽  
Author(s):  
Layth Al Tmimi ◽  
Marc Van de Velde ◽  
Bart Meyns ◽  
Bart Meuris ◽  
Paul Sergeant ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Postoperative Delirium ◽  
Artery Bypass ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Off Pump ◽  
Confusion Assessment ◽  
Opcab Surgery ◽  
Pump Coronary Artery Bypass

AbstractBackground:To investigate the predictive value of S100 (biochemical marker of neuroglial injury) for the occurrence of postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass (OPCAB)-surgery.Methods:We enrolled 92 patients older than 18 years undergoing elective OPCAB-surgery. Serum-levels of S100 were determined at baseline (BL), end of surgery (EOS) and on the first postoperative day (PD1). Postoperatively, all-patients were evaluated daily until PD5 for the presence of POD using the confusion assessment method (CAM) or the confusion assessment method for the intensive care unit (CAM-ICU) for patients in the intensive care unit (ICU).Results:The overall incidence of POD was 21%. S100-values on PD1 significantly predicted the occurrence of POD during the later hospital stay [area under the curve (AUC)=0.724 (95% confidence interval (CI): 0.619–0.814); p=0.0001] with an optimal cut-off level of 123 pg mLConclusions:S100-levels <123 pg mL

scholarly journals Validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)

2014 ◽  
pp. 879 ◽  
Author(s):  
Tanyong Pipanmekaporn ◽  
Nahathai Wongpakaran ◽  
Sirirat Mueankwan ◽  
Piyawat Dendumrongkul ◽  
Kaweesak Chittawatanarat ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Validity And Reliability ◽  
Confusion Assessment
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