Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization.

The analysis used only Eskenazi Hospital patients from a three-hospital trial cohort because complete utilization data were available, so results may not apply to other hospitals or populations. Patients had to be alive at hospital discharge and have screened positive for delirium, so the findings do not describe all ICU patients. Eight patients without post-randomization delirium or sedation assessments were excluded. Coma was imputed as the highest delirium severity score, which assumes coma and severe delirium carry the same severity burden. The study did not capture psychosocial factors, caregiver stress, skilled nursing placement, rehabilitation, home health services, cognition, or function. ED visits and hospitalizations are a crude measure of post-discharge healthcare burden and may miss other costs or needs.

Do not conclude that preventing or treating ICU delirium will reduce 2-year mortality. This analysis observed patients and found associations, not a treatment effect. Do not use ED visits or hospitalizations as outcomes to act on because neither delirium severity nor delirium or coma days was associated with them.