Pilarz Mary S, Pritchett Cara M, Tentinger Quinn, Li Jiafeng, Zurca Adrian D
Division of Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Avenue, Chicago, IL, 60611, USA.
Feinberg School of Medicine, Northwestern University, Chicago, USA.
Pediatr Cardiol. 2025 Sep 16. doi: 10.1007/s00246-025-04016-y.
To characterize the relationship between the use of a language other than English (LOE) and the prevalence of delirium in the pediatric cardiac intensive care unit (CICU), hypothesizing that patients from families who use an LOE would have a higher prevalence of delirium compared to those from English-speaking families. This was a retrospective cohort study at a quaternary-care, free-standing children's hospital CICU. Children admitted to the CICU between January 1, 2017, And July 31, 2023 with documented delirium screening scores were included. The primary outcome was the presence of delirium, assessed using the Cornell Assessment of Pediatric Delirium (CAP-D) score, with scores ≥ 9 indicating delirium. Language was recorded in the electronic health record and categorized as English, Spanish, or language other than English or Spanish (LOES). Covariates included age, sex, length of stay, developmental delay, use of mechanical ventilation, use of physical restraints, receipt of vasoactive medications, And caregiver presence. Among 1865 patients with CAP-D scores, 25.6% (477 patients) experienced delirium. Neither Spanish-speaking [adjusted OR (aOR) 1.43, 95% CI 0.92-2.22] nor LOES patients (aOR 0.73, 95% CI 0.33-1.60) demonstrated higher odds of delirium. Established risk factors for delirium, including age, length of stay, and mechanical ventilation, were associated with increased delirium risk. Inconsistent caregiver presence at bedside was associated with higher odds of delirium (aOR 2.37, 95% CI 1.76-3.18). In this CICU cohort, there was no significant association between the use of an LOE and delirium in the CICU. There is a strong, independent relationship between inconsistent caregiver presence and delirium.
为了描述在儿科心脏重症监护病房(CICU)中使用英语以外的语言(LOE)与谵妄患病率之间的关系,研究假设使用LOE的家庭中的患者与说英语家庭的患者相比,谵妄患病率更高。这是一项在一家四级医疗、独立儿童医院的CICU进行的回顾性队列研究。纳入了2017年1月1日至2023年7月31日期间入住CICU且有记录的谵妄筛查分数的儿童。主要结局是谵妄的存在,使用康奈尔儿科谵妄评估(CAP-D)分数进行评估,分数≥9表明存在谵妄。语言在电子健康记录中记录,并分类为英语、西班牙语或英语和西班牙语以外的语言(LOES)。协变量包括年龄、性别、住院时间、发育迟缓、机械通气的使用、身体约束的使用、血管活性药物的使用以及护理人员的在场情况。在1865名有CAP-D分数的患者中,25.6%(477名患者)经历了谵妄。说西班牙语的患者[调整后的比值比(aOR)1.43,95%置信区间0.92 - 2.22]和LOES患者(aOR 0.73,95%置信区间0.33 - 1.60)均未表现出更高的谵妄几率。已确定的谵妄危险因素,包括年龄、住院时间和机械通气,与谵妄风险增加相关。床边护理人员在场情况不一致与更高谵妄几率相关(aOR 2.37,95%置信区间1.76 - 3.18)。在这个CICU队列中,使用LOE与CICU中的谵妄之间没有显著关联。护理人员在场情况不一致与谵妄之间存在强烈的独立关系。