The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients

Ishaq Lat, Wes McMillian, Scott Taylor, Jeff M Janzen, Stella Papadopoulos, Laura Korth, As'ad Ehtisham, Joe Nold, Suresh Agarwal, Ruben Azocar, Peter Burke
Critical Care Medicine 2009, 37 (6): 1898-905

OBJECTIVE: Previously, delirium has been identified as an independent risk factor for mortality in critically ill medical patients. We undertook this study to examine the relationships among medication usage, delirium, and clinical outcomes in a critically ill surgical/trauma population.

DESIGN: Prospective, multicentered, observational study.

SETTING: Two surgical intensive care units in level 1 trauma centers.

PATIENTS: One hundred thirty-four consecutive surgical adult patients requiring mechanical ventilation (MV) for greater than 24 hours.

INTERVENTIONS: Daily delirium assessment with the Confusion Assessment Method-Intensive Care Unit tool, outcomes assessment, and prospective data collection.

MEASUREMENT AND MAIN RESULTS: Of the 134 patients who met inclusion criteria, 84 patients (63%) developed delirium at some point during their intensive care unit (ICU) stay. Delirium was associated with more MV days (9.1 vs. 4.9 days, p < 0.01), longer ICU stay (12.2 vs. 7.4 days, p < 0.01), longer hospital stay (20.6 vs. 14.7 days, p < 0.01). Additionally, greater cumulative lorazepam dose (p = 0.012), and higher cumulative fentanyl dose (p = 0.035) were administered in the delirium group.

CONCLUSIONS: Delirium in the surgical/trauma ICU cohort is independently associated with more days requiring MV, longer ICU length of stay, and longer hospital length of stay. Additionally, greater amounts of lorazepam and fentanyl were administered to patients with delirium.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"