دورية أكاديمية
Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study.
العنوان: | Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study. |
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المؤلفون: | Wilson LD; Oxley College of Health Sciences, Communication Sciences, and Disorders, The University of Tulsa, Tulsa, OK, USA., Maiga AW; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Geriatric Research Education and Clinical Center, Surgical Services, Tennessee Valley Healthcare System, Nashville, TN, USA., Lombardo S; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Section of Acute Care Surgery, Division of General Surgery, Department of Surgery, University of Utah Health, Salt Lake City, UT, USA., Nordness MF; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA., Haddad DN; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; The Trauma Center at Penn, Philadelphia, PA, USA., Rakhit S; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA., Smith LF; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA., Rivera EL; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA., Cook MR; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Meharry Medical College, Nashville, TN, USA.; Department of Surgery, Temple University Hospital, Philadelphia, PA, USA., Thompson JL; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.; Devoted Health, Waltham, MA, USA., Raman R; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA., Patel MB; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt Center for Health Services Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA. mayur.b.patel@vumc.org.; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. mayur.b.patel@vumc.org.; Geriatric Research Education and Clinical Center, Surgical Services, Tennessee Valley Healthcare System, Nashville, TN, USA. mayur.b.patel@vumc.org. |
المصدر: | Neurocritical care [Neurocrit Care] 2023 Jun; Vol. 38 (3), pp. 752-760. Date of Electronic Publication: 2023 Jan 31. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Humana Press Country of Publication: United States NLM ID: 101156086 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-0961 (Electronic) Linking ISSN: 15416933 NLM ISO Abbreviation: Neurocrit Care Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Totowa, NJ : Humana Press, c2004- |
مواضيع طبية MeSH: | Brain Injuries, Traumatic*/complications , Brain Injuries, Traumatic*/epidemiology , Subarachnoid Hemorrhage*/complications , Delirium*/epidemiology , Delirium*/etiology, Adult ; Humans ; Retrospective Studies ; Prevalence ; Risk Factors ; Intensive Care Units ; Glasgow Coma Scale |
مستخلص: | Background: Delirium remains understudied after traumatic brain injury (TBI). We sought to identify independent predictors of delirium among intensive care unit (ICU) patients with TBI. Methods: This single-center retrospective cohort study evaluated adult patients with TBI requiring ICU admission. Outcomes included delirium days within the first 14 days, as assessed by the Confusion Assessment Method-ICU (CAM-ICU). Models were adjusted for age, sex, insurance, Marshall head computed tomography classification, presence of subarachnoid hemorrhage (SAH), Injury Severity Score (ISS), need for cardiopulmonary resuscitation, maximum admission Glasgow Coma motor score, glucose level, hemoglobin level, and pupil reactivity. Results: Delirium prevalence was 60%, with a median duration of 4 days (interquartile range: 2-8) among ICU patients with TBI (n = 2,664). Older age, higher ISS, maximum motor score < 6, Marshall class II-IV, and SAH were associated with risk of increased delirium duration (all p < 0.001). Conclusions: In this large cohort, ICU delirium after TBI affected three of five patients for a median duration of 4 days. Age, general injury severity, motor score, and features of intracranial hemorrhage were predictive of more TBI-associated delirium days. Given the high prevalence of ICU delirium after TBI and its impact on hospitalization, further work is needed to understand the impact of delirium and TBI on outcomes and to determine whether delirium risk can be minimized. (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.) |
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معلومات مُعتمدة: | UL1 TR000445 United States TR NCATS NIH HHS; T32 CA106183 United States CA NCI NIH HHS; R01 GM120484 United States GM NIGMS NIH HHS; F32 AG062045 United States AG NIA NIH HHS; T32 GM135094 United States GM NIGMS NIH HHS; I01 RX002992 United States RX RRD VA; R01 AG058639 United States AG NIA NIH HHS |
فهرسة مساهمة: | Keywords: Critical illness; Delirium; Mental status; Predictors; Traumatic brain injury |
تواريخ الأحداث: | Date Created: 20230131 Date Completed: 20230607 Latest Revision: 20231227 |
رمز التحديث: | 20231227 |
مُعرف محوري في PubMed: | PMC10750768 |
DOI: | 10.1007/s12028-022-01666-1 |
PMID: | 36720836 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1556-0961 |
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DOI: | 10.1007/s12028-022-01666-1 |