Authors : Vijayalekshmi .S, Krishnadas .N C, Rajmohan Velayudhan, Krishnan .R
DOI : 10.18231/2455-8451.2018.0019
Volume : 4
Issue : 2
Year : 0
Page No : 73-77
Introduction: Delirium causes serious in-hospital morbidity.
Aims: Prevalence, risk factors and outcome of delirium were studied in a medical ICU.
Materials and Methods: This prospective study in the medical ICU identified delirium by CAM (Confusion Assessment Method). Comorbidities were assessed by Charlson Comorbidity Index. Socio-demographics, clinical parameters and outcome required a structured questionnaire. Data was analyzed using chi- square test, Pearson correlation and independent sample t test.
Results: Of 467 patients assessed, 101satisfied CAM diagnosis of delirium (prevalence-21.6%). Females predominated (51.5%); average age was 59.6 years. Acute exacerbation of chronic obstructive pulmonary disease (COPD) was the most common illness, diabetes mellitus (58.4%) followed by hypertension (17.8%) the most common co-morbidities. Leukocytosis, raised serum creatinine and abnormal EEG were observed. 77.2% had nasogastric feeding, 22.8% needed ventilator support.76.2% of patients were on some medication. Delirium was hyperactive in 78.2%, idiopathic in 38.6%. Hypoactive delirium, the least common, was associated with acute pulmonary oedema and sepsis (51.3%). (p=0.009). Delirium resolved completely in 80.2%. Mortality rate was 13.9%. 78.6% patients died within 72 hours (p=0.008); death was increased in those with respiratory findings (p=0.01) and ventilator (p<0.001).
Conclusion: A high prevalence of delirium was found in the Medical ICU. This was mostly hyperactive and idiopathic. Hypoactive delirium, the least common, was found associated with acute pulmonary oedema, sepsis. Acute exacerbation of COPD was the most common cause. Those with respiratory findings and on ventilator had higher mortality.
Keywords: Delirium, Intensive care, Hypoactive delirium, Ventilator, Mortality.