Trajectory and risk factors of cognitive level in ICU delirium patients after transfer out of the ICU: a protocol for a prospective cohort study.

INTRODUCTION

Delirium is a prevalent neuropsychiatric disorder in the intensive care unit (ICU), associated with poorer health outcomes, including extended duration of mechanical ventilation, prolonged ICU stays, and persistent or long-term cognitive impairment. Substantial evidence has indicated that the frequency, duration and severity of delirium during hospitalisation are significant risk factors for cognitive dysfunction in patients after ICU discharge. While existing studies have investigated the association between ICU delirium and subsequent cognitive outcomes, their analytical approaches have predominantly employed conventional longitudinal methods. Such methodological constraints impede the detection of clinically meaningful heterogeneous patient populations and the comprehensive evaluation of subgroup-specific determinants. The Latent Growth Curve Model (LGCM) and the Latent Class Growth Model (LCGM) serve as statistical tools capable of delineating the trajectory of cognitive change following delirium, along with identifying subgroups exhibiting distinct patterns of change. These methods may uncover clinically significant subtypes that were previously unrecognised. Therefore, this study aims to employ LGCM and LCGM to analyse the trajectory of cognitive level and risk factors in patients with delirium in the ICU one year after transfer.

METHODS AND ANALYSIS

This prospective study aims to investigate the 1-year trajectory of cognitive changes in ICU patients with delirium. It is planned to recruit 250 participants and gather comprehensive data, including general demographics, disease-related information and scores from the Mini-Mental State Examination, Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index. All data will be collected at the following time points: on the day of ICU transfer, 1 month post-transfer, 3 months post-transfer, 6 months post-transfer and 1 year post-transfer. Ultimately, we will employ LGCM and LCGM to analyse the trajectory of cognitive changes and identify potential subgroups, while conducting logistic regression analysis to explore risk factors. The results of this study will provide a theoretical framework for the clinical implementation of precision nursing interventions within this demographic, aiming to prevent or mitigate cognitive decline and improve patients' quality of life.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the ethics committee of Guizhou Nursing Vocational College (ethical approval number: gzhlllscb-2024-09-01). The findings of this study will be disseminated on a national and international scale through the publication of scholarly articles in research journals.

TRIAL REGISTRATION NUMBER

NCT06674603.