Long term outcome after delirium in the intensive care unit.

AIMS AND OBJECTIVES: This research studied the long term outcome of intensive care delirium defined as mortality and quality of life at three and six months after discharge of the intensive care unit.

BACKGROUND: Delirium in the intensive care unit is known to result in worse outcomes. Cognitive impairment, a longer stay in the hospital or in the intensive care unit and a raised mortality have been reported.

DESIGN: A prospective cohort study.

METHODS: A population of 105 consecutive patients was included during the stay at the intensive care unit in July-August 2006. The population was assessed once a day for delirium using the NEECHAM Confusion Scale and the CAM-ICU. Patients were visited at home by a nurse researcher to assess the quality of life using the Medical Outcomes Study Short-Form General Health Survey at three and six months after discharge of the intensive care unit. Delirious and non delirious patients were compared for mortality and quality of life.

RESULTS: Compared to the non delirious patients, more delirious patients died. The total study population discharged from the intensive care unit, scored lower for quality of life in all domains compared to the reference population. The domains showed lower results for the delirious patients compared to the non delirious patients.

CONCLUSIONS: Mortality was higher in delirious patients. All patients showed lower values for the quality of life at three months. The delirious patients showed lower results than the non delirious patients.

RELEVANCE TO CLINICAL PRACTICE: Nurses are the first caregivers to observe patients. The fluctuating delirious process is often not noticed. Long term effects are not visible to the interdisciplinary team in the hospital. This paper would like to raise the awareness of professionals for long term outcomes for patients having experienced delirium in the intensive care unit.