دورية أكاديمية
أعرض في EDS

Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study.

التفاصيل البيبلوغرافية
العنوان: Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study.
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.)
References: Lancet. 2009 May 30;373(9678):1874-82. (PMID: 19446324)
J Trauma. 2011 Oct;71(4):860-6. (PMID: 21537211)
Intensive Care Med. 2016 Jan;42(1):122-3. (PMID: 26170098)
JAMA. 2001 Dec 5;286(21):2703-10. (PMID: 11730446)
Lancet Neurol. 2022 Sep;21(9):803-813. (PMID: 35963263)
Crit Care Med. 2016 May;44(5):992-9. (PMID: 26741578)
Neurosurgery. 2017 Jan 01;80(1):6-15. (PMID: 27654000)
J Trauma. 2011 Apr;70(4):910-5. (PMID: 21610396)
Lancet Neurol. 2019 Oct;18(10):953-961. (PMID: 31451409)
J Trauma Acute Care Surg. 2013 Mar;74(3):876-83. (PMID: 23425751)
J Trauma. 2008 Jul;65(1):34-41. (PMID: 18580517)
Anesth Pain Med. 2021 Jul 27;11(3):e113802. (PMID: 34540634)
PLoS Med. 2008 Aug 5;5(8):e165; discussion e165. (PMID: 18684008)
Crit Care Med. 2018 Nov;46(11):1832-1841. (PMID: 30142098)
Crit Care Med. 2014 Feb;42(2):369-77. (PMID: 24158172)
BMJ. 2015 Jun 03;350:h2538. (PMID: 26041151)
Neurocrit Care. 2019 Jun;30(3):626-634. (PMID: 30506177)
Lancet Respir Med. 2018 Mar;6(3):213-222. (PMID: 29508705)
JAMA. 2018 Feb 20;319(7):680-690. (PMID: 29466591)
Ann Neurol. 2013 Feb;73(2):224-35. (PMID: 23224915)
N Engl J Med. 2013 Oct 3;369(14):1306-16. (PMID: 24088092)
Lancet Neurol. 2018 Sep;17(9):782-789. (PMID: 30054151)
JAMA. 2009 Feb 4;301(5):489-99. (PMID: 19188334)
J Intensive Care Med. 2019 Apr;34(4):330-336. (PMID: 28335673)
Am J Surg. 2008 Dec;196(6):864-9; discussion 869-70. (PMID: 19095101)
Crit Care Med. 2015 Mar;43(3):557-66. (PMID: 25493968)
JAMA. 2007 Dec 12;298(22):2644-53. (PMID: 18073360)
Am J Respir Crit Care Med. 2002 Nov 15;166(10):1338-44. (PMID: 12421743)
Crit Care Med. 2012 Jan;40(1):112-8. (PMID: 21926597)
Intensive Care Med. 2008 Jul;34(7):1263-8. (PMID: 18297270)
N Engl J Med. 2018 Dec 27;379(26):2506-2516. (PMID: 30346242)
MMWR Surveill Summ. 2017 Mar 17;66(9):1-16. (PMID: 28301451)
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
الوصف
تدمد:1556-0961
DOI:10.1007/s12028-022-01666-1