ICU-Delirium and Outcome; Sure / Nope / Maybe?

Background: Intensive care unit (ICU) patients’ delirium has gained its desired importance and better evaluated, recently. Predelirich score (Pre-S) was assumed as a useful tool to assess delirium in ICU patients.

Objective: This study was subjected to evaluate delirium in ICU patients and any possible relation with patients’ outcome.

Method: An annual retrospective analysis of patients’ data (2016) was performed, at respect of APACHE II scores, Pre-S’s and patients’ outcomes, in mixed-type ICU. Hence, APACHE II score was assumed as a reliable tool, and almost reflect physical condition and predicted mortality of any ICU patient, cases were weighted by APACHE II scores, in able to provide safety for possible biases. A possible effect of Pre-S on patients’ outcome was evaluated.

Results: Total of 347 patients were evaluated with mean age of 63±17, APACHE II score 19±9, and Pre-S of 38(4-92). Pre-S was significantly correlated (p:0.001) with patient mortality, although low in statistical power (r:180). Kaplan-Meier analysis showed; the higher Pre-S’s were significantly related to the higher patient mortality (LogRank, x²:121, p:0.003). ROC analysis to test this hypothesis revealed a relation of p:0.001, but relatively low in power (AUC:606) either. Survival function analysis, showed at figure 1, pointed out the relation between Pre-S and patient mortality.

Conclusion: However, delirium could not account for a strong predictive factor for ICU outcome, accumulating data have pointed out somehow-effects. Therefore, “delirium assessment, recognition and treatment” would be wise to keep in mind assuming as a recent “should”, possibly one of “musts” of near future.