Outcome, demography and resource utilization in ICU Patients with delirium and malignancy

Abstract Delirium in the general intensive care unit (ICU) population is common, associated with adverse outcomes and well studied. However, knowledge on delirium in the increasing number of ICU patients with malignancy is scarce. The aim was to assess the frequency of delirium and its impact on res...

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Autores principales:	Mattia Sieber, Alain Rudiger, Reto Schüpbach, Bernard Krüger, Maria Schubert, Dominique Bettex
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8039538949cf4323ad15b08bfc0e9f0f
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spelling	oai:doaj.org-article:8039538949cf4323ad15b08bfc0e9f0f2021-12-02T15:14:55ZOutcome, demography and resource utilization in ICU Patients with delirium and malignancy10.1038/s41598-021-98200-82045-2322https://doaj.org/article/8039538949cf4323ad15b08bfc0e9f0f2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98200-8https://doaj.org/toc/2045-2322Abstract Delirium in the general intensive care unit (ICU) population is common, associated with adverse outcomes and well studied. However, knowledge on delirium in the increasing number of ICU patients with malignancy is scarce. The aim was to assess the frequency of delirium and its impact on resource utilizations and outcomes in ICU patients with malignancy. This retrospective, single-center longitudinal cohort study included all patients with malignancy admitted to ICUs of a University Hospital during one year. Delirium was diagnosed by an Intensive Care Delirium Screening Checklist (ICDSC) score ≥ 4. Of 488 ICU patients with malignancy, 176/488 (36%) developed delirium. Delirious patients were older (66 [55–72] vs. 61 [51–69] years, p = 0.001), had higher SAPS II (41 [27–68] vs. 24 [17–32], p < 0.001) and more frequently sepsis (26/176 [15%] vs. 6/312 [1.9%], p < 0.001) and/or shock (30/176 [6.1%] vs. 6/312 [1.9%], p < 0.001). In multivariate analysis, delirium was independently associated with lower discharge home (OR [95% CI] 0.37 [0.24–0.57], p < 0.001), longer ICU (HR [95% CI] 0.30 [0.23–0.37], p < 0.001) and hospital length of stay (HR [95% CI] 0.62 [0.50–0.77], p < 0.001), longer mechanical ventilation (HR [95% CI] 0.40 [0.28–0.57], p < 0.001), higher ICU nursing workload (B [95% CI] 1.92 [1.67–2.21], p < 0.001) and ICU (B [95% CI] 2.08 [1.81–2.38], p < 0.001) and total costs (B [95% CI] 1.44 [1.30–1.60], p < 0.001). However, delirium was not independently associated with in-hospital mortality (OR [95% CI] 2.26 [0.93–5.54], p = 0.074). In conclusion, delirium was a frequent complication in ICU patients with malignancy independently associated with high resource utilizations, however, it was not independently associated with in-hospital mortality.Mattia SieberAlain RudigerReto SchüpbachBernard KrügerMaria SchubertDominique BettexNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mattia Sieber Alain Rudiger Reto Schüpbach Bernard Krüger Maria Schubert Dominique Bettex Outcome, demography and resource utilization in ICU Patients with delirium and malignancy
description	Abstract Delirium in the general intensive care unit (ICU) population is common, associated with adverse outcomes and well studied. However, knowledge on delirium in the increasing number of ICU patients with malignancy is scarce. The aim was to assess the frequency of delirium and its impact on resource utilizations and outcomes in ICU patients with malignancy. This retrospective, single-center longitudinal cohort study included all patients with malignancy admitted to ICUs of a University Hospital during one year. Delirium was diagnosed by an Intensive Care Delirium Screening Checklist (ICDSC) score ≥ 4. Of 488 ICU patients with malignancy, 176/488 (36%) developed delirium. Delirious patients were older (66 [55–72] vs. 61 [51–69] years, p = 0.001), had higher SAPS II (41 [27–68] vs. 24 [17–32], p < 0.001) and more frequently sepsis (26/176 [15%] vs. 6/312 [1.9%], p < 0.001) and/or shock (30/176 [6.1%] vs. 6/312 [1.9%], p < 0.001). In multivariate analysis, delirium was independently associated with lower discharge home (OR [95% CI] 0.37 [0.24–0.57], p < 0.001), longer ICU (HR [95% CI] 0.30 [0.23–0.37], p < 0.001) and hospital length of stay (HR [95% CI] 0.62 [0.50–0.77], p < 0.001), longer mechanical ventilation (HR [95% CI] 0.40 [0.28–0.57], p < 0.001), higher ICU nursing workload (B [95% CI] 1.92 [1.67–2.21], p < 0.001) and ICU (B [95% CI] 2.08 [1.81–2.38], p < 0.001) and total costs (B [95% CI] 1.44 [1.30–1.60], p < 0.001). However, delirium was not independently associated with in-hospital mortality (OR [95% CI] 2.26 [0.93–5.54], p = 0.074). In conclusion, delirium was a frequent complication in ICU patients with malignancy independently associated with high resource utilizations, however, it was not independently associated with in-hospital mortality.
format	article
author	Mattia Sieber Alain Rudiger Reto Schüpbach Bernard Krüger Maria Schubert Dominique Bettex
author_facet	Mattia Sieber Alain Rudiger Reto Schüpbach Bernard Krüger Maria Schubert Dominique Bettex
author_sort	Mattia Sieber
title	Outcome, demography and resource utilization in ICU Patients with delirium and malignancy
title_short	Outcome, demography and resource utilization in ICU Patients with delirium and malignancy
title_full	Outcome, demography and resource utilization in ICU Patients with delirium and malignancy
title_fullStr	Outcome, demography and resource utilization in ICU Patients with delirium and malignancy
title_full_unstemmed	Outcome, demography and resource utilization in ICU Patients with delirium and malignancy
title_sort	outcome, demography and resource utilization in icu patients with delirium and malignancy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8039538949cf4323ad15b08bfc0e9f0f
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Outcome, demography and resource utilization in ICU Patients with delirium and malignancy

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