Sánchez-Hurtado Luis A, Hernández-Sánchez Nancy, Del Moral-Armengol Mario, Guevara-García Humberto, García-Guillén Francisco J, Herrera-Gómez Ángel, Ñamendys-Silva Silvio A
Department of Critical Care Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.
Department of Critical Care Medicine, Hospital Especialidades Centro Médico Nacional La Raza, Mexican Institute of Social Security, Mexico City, Mexico.
Pain Res Manag. 2018 Jul 8;2018:4193275. doi: 10.1155/2018/4193275. eCollection 2018.
The aim of this study was to estimate the incidence of delirium and its risk factors among critically ill cancer patients in an intensive care unit (ICU).
This is a prospective cohort study. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was measured daily at morning to diagnose delirium by a physician. Delirium was diagnosed when the daily was positive during a patient's ICU stay. All patients were followed until they were discharged from the ICU. Using logistic regression, we estimated potential risk factors for developing delirium. The primary outcome was the development of ICU delirium.
There were 109 patients included in the study. Patients had a mean age of 48.6 ± 18.07 years, and the main reason for admission to the ICU was septic shock (40.4%). The incidence of delirium was 22.9%. The mortality among all subjects was 15.6%; the mortality rate in patients who developed delirium was 12%. The only variable that had an association with the development of delirium in the ICU was the days of use of mechanical ventilation (OR: 1.06; CI 95%: 0.99-1.13;=0.07).
Delirium is a frequent condition in critically ill cancer patients admitted to the ICU. The duration in days of mechanical ventilation is potential risk factors for developing delirium during an ICU stay. Delirium was not associated with a higher rate of mortality in this group of patients.
本研究旨在评估重症监护病房（ICU）中重症癌症患者谵妄的发生率及其危险因素。
这是一项前瞻性队列研究。由医生每天早晨使用重症监护病房意识模糊评估法（CAM-ICU）来诊断谵妄。当患者在ICU住院期间每日评估结果为阳性时，即诊断为谵妄。所有患者均随访至从ICU出院。我们使用逻辑回归分析来评估发生谵妄的潜在危险因素。主要结局是发生ICU谵妄。
本研究共纳入109例患者。患者的平均年龄为48.6±18.07岁，入住ICU的主要原因是感染性休克（40.4%）。谵妄的发生率为22.9%。所有受试者的死亡率为15.6%；发生谵妄的患者死亡率为12%。在ICU中，唯一与谵妄发生相关的变量是机械通气使用天数（比值比：1.06；95%置信区间：0.99-1.13；P=0.07）。
谵妄在入住ICU的重症癌症患者中很常见。机械通气的天数是ICU住院期间发生谵妄的潜在危险因素。在这组患者中，谵妄与较高的死亡率无关。
