Incidence and risk factors for delirium in critically ill patients with severe acute pancreatitis: a multicenter cohort study

<b>BACKGROUND:</b> Severe acute pancreatitis (SAP) is commonly associated with acute organ failure, but its effects on cerebral function within intensive care unit (ICU) patients remains inadequately researched. This study aims to determine the prevalence of delirium in critically ill patients diagnosed with SAP, and to identify risk factors associated with delirium in this patient population. <b>METHODS:</b> This was a retrospective, multicenter study, which enrolled adult patients diagnosed with SAP who admitted intensive care unit (ICU) for at least 24 h. Patient assessment was conducted using the Richmond Agitation-Sedation Scale (RASS) and the Confusion Assessment Method for the ICU (CAM-ICU). The cumulative incidence of delirium was determined. Demographic, clinical data, and length of ICU stay were compared between patients with and without delirium. A logistic regression model was employed to identify potential risk factors for delirium. <b>RESULTS:</b> A total of 1,814 patients were included from seven hospitals in Anhui province, China. Delirium was observed in 25.2% of patients. Logistic regression analysis identified APACHE II scores (odds ratio [<i>OR</i>]=3.37, 95% confidence interval [<i>CI</i>]: 1.09-10.43, <i>P</i>=0.04), physical restraint (<i>OR</i>=11.11, 95%<i>CI</i>: 4.35-28.39, <i>P</i><0.05), invasive mechanical ventilation (IMV) (<i>OR</i>=2.44, 95%<i>CI</i>: 1.41-4.25, <i>P</i>=0.002), and ICU length of stay ≥ 7 days (<i>OR</i>=3.14, 95%<i>CI</i>: 2.27-4.36, <i>P</i><0.05) as independent risk factors of delirium. <b>CONCLUSION:</b> The present study revealed a substantial incidence of delirium in critically ill patients with SAP, associated with factors including APACHE II score, IMV, physical restraint, and prolonged ICU stays.