دورية أكاديمية
أعرض في EDS

Factors associated with persistent delirium after intensive care unit admission in an older medical patient population.

التفاصيل البيبلوغرافية
العنوان: Factors associated with persistent delirium after intensive care unit admission in an older medical patient population.
المؤلفون: Pisani MA; Department of Internal Medicine, Pulmonary and Critical Care Section, and the Program on Aging, Yale University School of Medicine, New Haven, CT 06520-8057, USA. margaret.pisani@yale.edu, Murphy TE, Araujo KL, Van Ness PH
المصدر: Journal of critical care [J Crit Care] 2010 Sep; Vol. 25 (3), pp. 540.e1-7. Date of Electronic Publication: 2010 Apr 22.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8610642 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-8615 (Electronic) Linking ISSN: 08839441 NLM ISO Abbreviation: J Crit Care Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia Pa : W.B. Saunders
Original Publication: Orlando, FL : Grune & Stratton, c1986-
مواضيع طبية MeSH: Delirium*/chemically induced , Delirium*/epidemiology, Analgesics, Opioid/*adverse effects , Haloperidol/*adverse effects , Psychotropic Drugs/*adverse effects, Age Factors ; Aged ; Analysis of Variance ; Critical Care ; Dementia/epidemiology ; Humans ; Intensive Care Units ; Middle Aged ; Patient Admission ; Prospective Studies ; Risk Factors ; Severity of Illness Index
مستخلص: Purpose: This study was designed to identify factors associated with persistent delirium in an older medical intensive care unit (ICU) population.
Materials and Methods: This is a prospective cohort study of 309 consecutive medical ICU patients 60 years or older. Persistent delirium was defined as delirium occurring in the ICU and continuing upon discharge to the ward. The Confusion Assessment Method was used to assess for delirium. Patient demographics, severity of illness, and medication data were collected. Univariate and multivariate analysis were used to assess factors associated with persistent delirium.
Results: Of 309 consecutive admissions to the ICU, 173 patients had ICU delirium, survived the ICU stay, and provided ward data. One-hundred patients (58%) had persistent delirium. In a multivariable logistic regression model, factors significantly associated with persistent delirium included age more than 75 years (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.23-5.16), opioid (morphine equivalent) dose greater than 54 mg/d (OR, 2.90; 95% CI, 1.15-7.28), and haloperidol (OR, 2.88; 95% CI, 1.38-6.02); change in code status to "do not resuscitate" (OR, 2.62; 95% CI 0.95-7.35) and dementia (OR, 1.93; 95% CI 0.95-3.93) had less precise associations.
Conclusions: Age, use of opioids, and haloperidol were associated with persistent delirium. Further research is needed regarding the use of haloperidol and opioids on persistent delirium.
(Copyright © 2010 Elsevier Inc. All rights reserved.)
References: Ann Intern Med. 1990 Dec 15;113(12):941-8. (PMID: 2240918)
J Gerontol A Biol Sci Med Sci. 2003 Jan;58(1):76-81. (PMID: 12560416)
J Am Geriatr Soc. 2003 May;51(5):689-93. (PMID: 12752846)
J Am Geriatr Soc. 2003 May;51(5):591-8. (PMID: 12752832)
J Am Med Dir Assoc. 2007 Oct;8(8):549-50. (PMID: 17931586)
JAMA. 2001 Dec 5;286(21):2703-10. (PMID: 11730446)
Int Psychogeriatr. 2000 Mar;12(1):117-27. (PMID: 10798458)
Crit Care Med. 2001 Jul;29(7):1370-9. (PMID: 11445689)
N Engl J Med. 2006 Mar 16;354(11):1157-65. (PMID: 16540616)
J Am Geriatr Soc. 2005 Feb;53(2):312-8. (PMID: 15673358)
Drug Saf. 1999 Aug;21(2):101-22. (PMID: 10456379)
Intensive Care Med. 2007 Jan;33(1):66-73. (PMID: 17102966)
Cancer. 2007 Jun 1;109(11):2365-73. (PMID: 17469164)
Crit Care. 2006;10(4):R121. (PMID: 16919169)
Crit Care Med. 2004 Apr;32(4):955-62. (PMID: 15071384)
Crit Care Med. 2004 Jan;32(1):106-12. (PMID: 14707567)
Dement Geriatr Cogn Disord. 2005;20(4):262-9. (PMID: 16103670)
Anesthesiology. 2006 Jan;104(1):21-6. (PMID: 16394685)
Intensive Care Med. 2001 May;27(5):859-64. (PMID: 11430542)
Anesth Analg. 1998 Apr;86(4):781-5. (PMID: 9539601)
Psychol Med. 1994 Feb;24(1):145-53. (PMID: 8208879)
Intensive Care Med. 2001 Dec;27(12):1892-900. (PMID: 11797025)
JAMA. 2004 Apr 14;291(14):1753-62. (PMID: 15082703)
J Chronic Dis. 1987;40(5):373-83. (PMID: 3558716)
J Am Geriatr Soc. 2006 Mar;54(3):479-84. (PMID: 16551316)
Scand J Caring Sci. 1989;3(1):27-34. (PMID: 2740664)
Arch Intern Med. 2007 Aug 13-27;167(15):1629-34. (PMID: 17698685)
Psychosomatics. 2002 May-Jun;43(3):183-94. (PMID: 12075033)
معلومات مُعتمدة: 2P30AG021342-06 United States AG NIA NIH HHS; K23AG23023 United States AG NIA NIH HHS; P30 AG021342 United States AG NIA NIH HHS; K23 AG023023-05 United States AG NIA NIH HHS; K23 AG023023 United States AG NIA NIH HHS
المشرفين على المادة: 0 (Analgesics, Opioid)
0 (Psychotropic Drugs)
J6292F8L3D (Haloperidol)
تواريخ الأحداث: Date Created: 20100424 Date Completed: 20101213 Latest Revision: 20211020
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC2939229
DOI: 10.1016/j.jcrc.2010.02.009
PMID: 20413252
قاعدة البيانات: MEDLINE
الوصف
تدمد:1557-8615
DOI:10.1016/j.jcrc.2010.02.009