Zavaleta-Monestel Esteban, Martínez-Vargas Ernesto, Chaverri-Fernández José, Díaz-Madriz José Pablo, Fallas-Mora Abigail, Alvarado-Ajun Paola, Rojas-Chinchilla Carolina, García-Montero Jonathan
Pharmacy, Hospital Clínica Bíblica, San José, CRI.
College of Medicine, Universidad de Costa Rica, San José, CRI.
Cureus. 2024 Sep 23;16(9):e70007. doi: 10.7759/cureus.70007. eCollection 2024 Sep.
Delirium is a common and serious neurological complication in intensive care units (ICUs), often leading to poor patient outcomes and increased mortality. This study aimed to compare the incidence of delirium in ICU patients with COVID-19 to those with other respiratory infections in a private hospital in Costa Rica. Additionally, it evaluated the prevalence, severity, duration, and treatment of delirium in these critically ill patients.
A retrospective observational study was conducted, analyzing multiple variables obtained from the electronic health records of patients hospitalized in the ICU of Hospital Clinica Biblica. The study included patients admitted between January 2020 and December 2023. It compared the incidence of delirium among patients admitted for COVID-19 and those admitted for other diagnoses. The main outcomes measured were the incidence of delirium and the correlation of its management with international guidelines. The measures included the use of mechanical ventilation, the development of delirium, and the use of sedatives.
A total of 137 patients were analyzed, of whom 57.7% were over 70 years old, 67.2% were men, 45.2% were admitted with a diagnosis of COVID-19, 90.5% used mechanical ventilation, and 49.6% of patients developed delirium. Dexmedetomidine was the most used sedative, which was the only one that showed a significant relationship with the development of delirium (p=0.0002). Delirium management was mainly done through the administration of dexmedetomidine (52.9%) and quetiapine (41.2%). There was no correlation between delirium development and mortality (p=0.2670).
The study results do not show a significant relationship between COVID-19-positive patients and the development of delirium. Similarly, no higher mortality was observed in those patients who experienced delirium during their ICU stay.
谵妄是重症监护病房（ICU）中常见且严重的神经并发症，常导致患者预后不良和死亡率增加。本研究旨在比较哥斯达黎加一家私立医院中感染新型冠状病毒肺炎（COVID-19）的ICU患者与其他呼吸道感染患者的谵妄发生率。此外，还评估了这些重症患者谵妄的患病率、严重程度、持续时间及治疗情况。
进行了一项回顾性观察研究，分析了从圣经临床医院ICU住院患者电子健康记录中获取的多个变量。该研究纳入了2020年1月至2023年12月期间入院的患者。比较了因COVID-19入院患者和因其他诊断入院患者的谵妄发生率。主要测量结果为谵妄发生率及其管理与国际指南的相关性。测量指标包括机械通气的使用、谵妄的发生以及镇静剂的使用。
共分析了137例患者，其中57.7%年龄超过70岁，67.2%为男性，45.2%因COVID-19诊断入院，90.5%使用机械通气，49.6%的患者发生谵妄。右美托咪定是最常用的镇静剂，是唯一与谵妄发生有显著关系的药物（p = 0.0002）。谵妄管理主要通过给予右美托咪定（52.9%）和喹硫平（41.2%）进行。谵妄发生与死亡率之间无相关性（p = 0.2670）。
研究结果未显示COVID-19阳性患者与谵妄发生之间存在显著关系。同样，在ICU住院期间发生谵妄的患者中未观察到更高的死亡率。
