Sadaf Fnu, Saqib Muhammad, Iftikhar Muhammad, Ahmad Afaq
Department of Primary and Secondary Healthcare, Basic Healthcare Unit, Verpal Chattha, Gujranwala, PAK.
Department of Internal Medicine, Khyber Teaching Hospital, Peshawar, PAK.
Cureus. 2023 Sep 7;15(9):e44827. doi: 10.7759/cureus.44827. eCollection 2023 Sep.
Background Delirium is a common and serious complication among critically ill patients in the intensive care unit. Knowledge of the risk factors of delirium can help tremendously in the diagnosis of delirium. Methods In April of 2023, a cross-sectional multicenter study was conducted in eight intensive care units (ICUs) across Pakistan. Delirium was assessed using the intensive care delirium screening checklist. Demographic and clinical data were collected, and multivariable logistic regression analysis was performed to identify predictors of delirium. A total of 256 patients were enrolled in the study. Results The mean age of participants was 56 (S.D. 12) years. The point prevalence of delirium was 39%, and the point prevalence did not vary significantly among the participating intensive care units. Advanced age, higher Acute Physiology and Chronic Health Evaluation - IV (APACHE IV) scores, and higher Richmond Agitation-Sedation Scale (RASS) scores at enrollment were identified as significant predictors of delirium. Conclusion The high prevalence of delirium, observed at 39.0%, emphasizes the importance of proactive screening and effective management strategies in the ICU setting. Healthcare providers in Pakistan should be mindful of these risk factors and implement preventive measures to minimize the occurrence of delirium in critically ill patients. Further research and implementation of targeted interventions are warranted to improve patient outcomes and enhance the overall quality of care in this population.
谵妄是重症监护病房中危重症患者常见且严重的并发症。了解谵妄的危险因素对谵妄的诊断有极大帮助。方法:2023年4月,在巴基斯坦的8个重症监护病房开展了一项横断面多中心研究。使用重症监护谵妄筛查清单评估谵妄。收集人口统计学和临床数据,并进行多变量逻辑回归分析以确定谵妄的预测因素。共有256名患者纳入研究。结果:参与者的平均年龄为56(标准差12)岁。谵妄的时点患病率为39%,且在参与研究的重症监护病房中,时点患病率无显著差异。高龄、较高的急性生理与慢性健康状况评估IV(APACHE IV)评分以及入组时较高的里士满躁动镇静量表(RASS)评分被确定为谵妄的显著预测因素。结论:观察到的39.0%的谵妄高患病率强调了在重症监护病房环境中进行主动筛查和有效管理策略的重要性。巴基斯坦的医疗保健提供者应注意这些危险因素,并实施预防措施以尽量减少危重症患者谵妄的发生。有必要进一步开展研究并实施针对性干预措施,以改善患者预后并提高该人群的整体护理质量。