Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro, 173, Beon-gil, Bundang-gu, Seongnam, 13620, South Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
BMC Pulm Med. 2021 Nov 1;21(1):341. doi: 10.1186/s12890-021-01714-0.
The prevalence of delirium, its associated factors, and its impact on long-term mortality among survivors of acute respiratory distress syndrome (ARDS) is unclear.
Since this was a population-based study, data were extracted from the National Health Insurance database in South Korea. All adults who were admitted to intensive care units with a diagnosis of ARDS between January 1, 2010, and December 31, 2019, and who survived for ≥ 60 days were included. The International Statistical Classification of Diseases and Related Health Problems, tenth revision code of delirium (F05) was used to extract delirium cases during hospitalization.
A total of 6809 ARDS survivors were included in the analysis, and 319 patients (4.7%) were diagnosed with delirium during hospitalization. In the multivariable logistic regression analysis after covariate adjustment, male sex (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.23, 2.08; P < 0.001), longer duration of hospitalization (OR 1.02, 95% CI 1.01, 1.03; P < 0.001), neuromuscular blockade use (OR 1.50, 95% CI 1.12, 2.01; P = 0.006), benzodiazepine (OR 1.55, 95% CI 1.13, 2.13; P = 0.007) and propofol (OR 1.48, 95% CI 1.01, 2.17; P = 0.046) continuous infusion, and concurrent depression (OR 1.31, 95% CI 1.01, 1.71; P = 0.044) were associated with a higher prevalence of delirium among ARDS survivors. In the multivariable Cox regression analysis after adjustment for covariates, the occurrence of delirium was not significantly associated with 1-year all-cause mortality, when compared to the other survivors who did not develop delirium (hazard ratio: 0.85, 95% CI 1.01, 1.71; P = 0.044).
In South Korea, 4.7% of ARDS survivors were diagnosed with delirium during hospitalization in South Korea. Some factors were potential risk factors for the development of delirium, but the occurrence of delirium might not affect 1-year all-cause mortality among ARDS survivors.
急性呼吸窘迫综合征（ARDS）幸存者中谵妄的发生率、相关因素及其对长期死亡率的影响尚不清楚。
由于这是一项基于人群的研究，数据从韩国国家健康保险数据库中提取。2010 年 1 月 1 日至 2019 年 12 月 31 日期间，所有因 ARDS 入住重症监护病房且存活≥60 天的成年人均被纳入研究。使用国际疾病分类第十版（ICD-10）谵妄（F05）代码在住院期间提取谵妄病例。
共纳入 6809 例 ARDS 幸存者，其中 319 例（4.7%）在住院期间被诊断为谵妄。在调整协变量后的多变量逻辑回归分析中，男性（比值比[OR] 1.60，95%置信区间[CI] 1.232.08；P<0.001）、住院时间较长（OR 1.02，95% CI 1.011.03；P<0.001）、使用神经肌肉阻滞剂（OR 1.50，95% CI 1.122.01；P=0.006）、苯二氮䓬类药物（OR 1.55，95% CI 1.132.13；P=0.007）和丙泊酚（OR 1.48，95% CI 1.012.17；P=0.046）持续输注以及并发抑郁（OR 1.31，95% CI 1.011.71；P=0.044）与 ARDS 幸存者谵妄发生率较高相关。在调整协变量后的多变量 Cox 回归分析中，与未发生谵妄的其他幸存者相比，谵妄的发生与 1 年全因死亡率无显著相关性（风险比：0.85，95% CI 1.01~1.71；P=0.044）。
在韩国，4.7%的 ARDS 幸存者在韩国住院期间被诊断为谵妄。一些因素可能是谵妄发生的潜在危险因素，但谵妄的发生可能不会影响 ARDS 幸存者 1 年的全因死亡率。
