• Ryy Wan, C A McKenzie, D Taylor, L Camporota, and M Ostermann.
• Department of Pharmacy, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK. Electronic address: Ruth.Wan@gstt.nhs.uk.
• J Crit Care. 2020 Feb 1; 55: 194-197.

PurposeDelirium and acute kidney injury (AKI) are common organ dysfunctions during critical illness. Both conditions are associated with serious short- and long-term complications. We investigated whether AKI is a risk factor for hyperactive delirium.MethodsThis was a single-centre case control study conducted in a 30 bedded mixed Intensive Care Unit in the UK. Hyperactive delirium cases were identified by antipsychotic initiation and confirmation of delirium diagnosis through validated chart review. Cases were compared with non-delirium controls matched by Acute Physiology and Chronic Health Evaluation II score and gender. AKI was defined by the KDIGO criteria.Results142 cases and 142 matched controls were identified. AKI stage 3 was independently associated with hyperactive delirium [Odds ratio (OR) 5.40 (95% confidence interval (CI) 2.33-12.51]. Other independent risk factors were mechanical ventilation [OR 2.70 (95% CI 1.40-5.21)], alcohol use disorder [OR 5.80 (95% CI 1.90-17.72)], and dementia [OR 9.76 (95% CI 1.09-87.56)]. Hospital length of stay was significantly longer in delirium cases (29 versus 20 days; p = .004) but hospital mortality was not different.ConclusionsAKI stage 3 is independently associated with hyperactive delirium. Further research is required to explore the factors that contribute to this association.Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.

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