Delirium at the Intensive Care Unit - a Retrospective Cohort Study

Zealand University Hospital

Status: Completed

Conditions: Delirium; Intensive Care Unit Syndrome

Study type: Observational

Funder types: Other

Identifiers

NCT02603731

SE-DELIR1-15

Details and patient eligibility

About

This project seeks to describe the incidence of delirium in the Intensive Care Unit (ICU) and to identify risk and preventive factors associated with development of delirium.

Especially, the investigators want to investigate if an imitated natural light/dark cycle influences frequency of delirium.

Full description

A common problem for patients in the ICU is episodes of delirium. Recent trials have described incidences ranging from 60-87% of patients in a number of different countries. Delirium is a condition with fluctuating conscience, disorganized thinking and disturbance of the sleep/wake cycle. Many patients with delirium experience hallucinations and agitation which can be very unpleasant for both patients and their families.

Some risk factors for the development of delirium well known, e.g. dementia, hypertension, illness severity (SAPS II score), delirium on the previous day, mechanical ventilation, emergency surgery and metabolic acidosis. The effect of sedative drug administration is not clear, as studies has been inconclusive.

Even though studies regarding the impact of sleep deprivation on development of delirium have been inconclusive, there is no doubt that delirious patients have a disturbed sleep-wake cycle, sleep architecture and circadian rhythm.

At the intensive care unit at the Department of Anesthesiology at Køge Hospital, three out of nine rooms have a simulated circadian light installed. The idea is that this light rhythm may help to keep a natural circadian rhythm, minimizing the risk of delirium.

With this descriptive and retrospective cohort study, the investigators therefore want to describe the incidence and possible risk- and preventive factors of delirium for the participants (ICU patients at Køge Hospital), and with a special focus on the possible effect of imitated circadian light..

Enrollment: 183 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients >18 years of age admitted to the ICU at Køge Hospital in the study period

Exclusion criteria

• Richmond Agitation Sedation Score (RASS): -4 or -5 during the whole study period
• No CAM-ICU scores during the ICU stay
• Unable to communicate in Danish (aphasic, deaf, non-Danish speaking, severe brain damage)
• Severe dementia documented in electronic patient charts (OPUS)
• Patients not receiving active treatment (moribund patients)