• Journal of critical care · Feb 2024

    Recurrent delirium episodes within the intensive care unit: Incidence and associated factors.

    • Christina Boncyk, Kimberly Rengel, Joanna Stollings, Matt Marshall, Xiaoke Feng, Matthew Shotwell, Pratik P Pandharipande, and Christopher G Hughes.
    • Department of Anesthesiology, Vanderbilt University Medical Center, United States of America; Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, University Medical Center, Vanderbilt, United States of America. Electronic address: christina.s.boncyk@vumc.org.
    • J Crit Care. 2024 Feb 1; 79: 154490154490.

    PurposeDescribe the incidence and factors associated with recurrent delirium in the intensive care unit (ICU).Materials And MethodsRetrospective study of ICU patients diagnosed with delirium. Delirium clearance defined as 48 h of negative delirium assessments following initial episode and recurrent delirium as any positive delirium assessment following clearance. Multivariable logistic regression model assessed independent association of patient and hospital factors on development of recurrent delirium, adjusting for pre-defined covariates.ResultsAmong 8591 ICU admissions identified with delirium, 1067 (12.4%) had recurrent symptoms. Factors associated with increased odds of recurrent delirium were age (nonlinear; p = 0.02), shock (OR 1.45, 95% CI [1.20, 1.75]), admission to medical (OR 3.25, 95% CI [2.42, 4.37]), surgical (OR 3.00, 95% CI [2.21, 4.06]), or trauma (OR 2.17, 95% CI [1.58, 3.00]) ICU vs. cardiovascular ICU, increased duration of mechanical ventilation (OR 2.43, 95% CI [2.22, 2.65]), propofol use (OR 1.35, 95% CI [1.02, 1.80]), and antipsychotic medications (haloperidol OR 1.53, 95% CI [1.26, 1.86]; quetiapine OR 2.45, 95% CI [1.98, 3.02]; and olanzapine OR 1.54, 95% CI [1.25, 1.88]).ConclusionsOver 10% of delirious ICU patients had recurrent symptoms. Factors associated with recurrence included age, duration of mechanical ventilation and medication exposure.Clinical Trial NumberNot applicable.Copyright © 2023 Elsevier Inc. All rights reserved.

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