Accuracy of delirium risk factors in adult intensive care unit patients.
Luciana Aparecida Costa Carvalho, Marisa Dibbern Lopes Correia, Ráisa Camilo Ferreira and 3 others
PMID 34989391WHAT IT FOUND
In an adult ICU, infection, severe illness, dehydration, low albumin, multiple invasive devices, bladder catheters, proton-pump inhibitors, and analgesics were linked to delirium.
Absence of mechanical ventilation or transfusion made delirium unlikely.
Key findings
01Of 102 adult ICU patients, 31 (30.4%) developed delirium during daily CAM-ICU assessment.
02Among invasive devices, an indwelling bladder catheter was the most predictive for delirium at sensitivity 0.8750, followed by central venous and nasoenteral catheters at sensitivity 0.7500.
03Among medication classes, only proton-pump inhibitors and analgesics were predictive for delirium, each with sensitivity 0.6875.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single university hospital ICU in Brazil, with a convenience sample of 102 patients over five months. The study unit had no systematic delirium identification, risk assessment, or preventive measures during the study period. Dementia was not assessed because it was not recorded in the medical records. Altered renal function could not be separated into acute and chronic changes. The paper notes that the number of patients with some risk factors could have been higher. Cognitive impairment was not assessed, and motor subtypes of delirium were not identified. The study measured accuracy of risk factors, not whether changing or removing a factor prevents delirium.
The easy way to misread this
Do not conclude that removing an indwelling bladder catheter or stopping proton-pump inhibitors prevents delirium. The study measured accuracy, not tested changes, and patients received many treatments together.