J Korean Soc Clin Toxicol.  2019 Jun;17(1):14-20. 10.22537/jksct.2019.17.1.14.

Risk Factors of Delirium in ICU Patients with Acute Poisoning

Affiliations
  • 1Department of Emergency Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggido, Korea. sohak@catholic.ac.kr

Abstract

PURPOSE
This study estimated the incidence of delirium and associated risk factors and outcomes in ICU patients with acute poisoning.
METHODS
Data were collected from ICU patients over 18 years of age that were admitted via the emergency center after presenting with poisoning from 2010 to 2015. Delirium was assessed retrospectively using the Intensive Care Delirium Screening Checklist (ICDSC). Risk factors were evaluated by univariate and multivariate analysis.
RESULTS
A total of 199 patients participated in this study and 68 (34.2%) were diagnosed with delirium based on the ICDSC score. The delirium group showed a significantly higher association with prolonged length of stay in the hospital and ICU in comparison with the non-delirium group. The delirium group was associated with greater use of physical restraint. A statistically greater number of patients with pharmaceutical substance poisoning developed delirium over a short period of time than those with non-pharmaceutical substance poisoning. There was no significant difference between the two groups with respect to age, sex, past history, GCS score, vital signs, application of ventilator care and renal replacement therapy.
CONCLUSION
The finding that the delirium group had a greater length of stay in both the hospital and the ICU is consistent with the results of previous worldwide studies of the effects of delirium on the prognosis of patients who were admitted to the ICU, suggesting the possibility for domestic application. Additionally, use of physical restraint was positively related to the incidence of delirium. Thus, interventions for minimizing the use of physical restraints and considering alternatives are needed.

Keyword

Delirium; Poisoning; Intensive care unit; Physical restraint

MeSH Terms

Checklist
Critical Care
Delirium*
Emergencies
Humans
Incidence
Intensive Care Units
Length of Stay
Mass Screening
Multivariate Analysis
Poisoning*
Prognosis
Renal Replacement Therapy
Restraint, Physical
Retrospective Studies
Risk Factors*
Ventilators, Mechanical
Vital Signs
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