Prevalence of Agitation and Its Associated Factors in Adult Intensive Care Unit: A Systematic Review and Meta-Analysis.
Temesgen Birlie Asmare, Getachew Mekete Diress, Negesse Zurbachew Gobezie and 8 others
PMID 41379067WHAT IT FOUND
Agitation was common in adult intensive care units, affecting 55.65% of patients across 10 studies.
Fever above 37.5°C was the only factor associated with agitation; pain, delirium, low sodium and restraints were not.
Key findings
01Agitation prevalence varied from 17.50% to 89.00%, with a pooled estimate of 55.65% (95% CI: 40.07 to 71.24).
02Hyperthermia above 37.5°C was the only factor significantly associated with agitation, with a pooled adjusted odds ratio of 3.24 (95% CI: 1.51 to 4.91).
03Pain, hyponatraemia, delirium and restraint use were not significantly associated with agitation in the pooled analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 10 studies and 1306 participants were pooled, so the estimate may not represent every adult ICU population. Heterogeneity was very high (I2 = 97.66%), because studies used different agitation definitions and tools, including RASS, RAMSAY, Riker and SAS. The included studies were observational, so fever and agitation are associated but causality cannot be inferred. The factor analyses were based on few studies: hyperthermia and pain from 3 studies each, and hyponatraemia, delirium and restraint use from 2 studies each. Publication bias could not be reliably ruled out because there were few studies, even though Egger's test was not significant (p = 0.4925). Only English studies were included, which may have omitted relevant non-English data.
Declared interests
The authors reported no funding and no conflicts of interest.
The easy way to misread this
Do not conclude that fever causes agitation or that treating fever will reduce agitation. The included studies were observational and highly heterogeneous, so hyperthermia is an associated factor rather than a proven cause.