Predisposing and precipitating factors for the development of postoperative delirium in critically ill patients in a university intensive care unit.
Danielle Moreira Marques, Davi da Silveira Barroso Alves, Taís Veronica Cardoso Vernaglia
PMID 39230174WHAT IT FOUND
Delirium occurred in 28% of 157 adults after non-cardiac surgery.
Older age, longer surgery, intraoperative sufentanil, transfusion, and no antiemetic were associated with delirium, so ICU nurses can monitor these patients more closely.
Key findings
01Postoperative delirium occurred in 44 of 157 patients (28%).
02In the adjusted model, older age and longer surgery time remained associated with delirium (age OR 1.037; surgery time OR 1.004).
03In the adjusted model, intraoperative sufentanil, blood transfusion, and no intraoperative antiemetic were associated with delirium (sufentanil OR 5.748; transfusion OR 3.814; antiemetic no OR 2.895).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one university hospital ICU that did not provide emergency care, so it may not apply to all surgical patients. It shows association, not causation; the authors say the factors may be related to an underlying cause not yet explained. Drug doses were not individualised, and some data were missing from medical records, including nutritional status and ASA risk. No sampling process was used; participants were all eligible patients who agreed during the follow-up period.
The easy way to misread this
Do not conclude that changing these drugs or fluids will prevent delirium. This was a single-centre observational cohort, and the authors state that association does not consolidate causality.