Determinants of delirium in the intensive care unit patients in the Jimma Medical Center, 2023: unmatched case-control study

Intensive care unit (ICU) delirium affects more than 50% of critically ill patients, hindering the proper clinical care by complicating the underlying medical or surgical conditions. There, it may result in higher risks of complications, longer periods of recovery, and death. Besides these crucial clinical concerns of delirium, there is a lack of evidence exploring the occurrence of delirium in the intensive care unit in Ethiopia. Therefore, we aimed to identify the determinants of delirium in the intensive care unit patients in the Jimma Medical Center (JMC), 2023. The unmatched case-control study was conducted from February 01/2024, to March 01/2024, at the Intensive Care Unit in the Jimma Medical Center. This study includes 127 participants (42 for cases and 85 for controls) using a simple random sampling. The Intensive Care Unit delirium was assessed by using the confusion assessment method for intensive care unit (CAM-ICU). A structured questionnaire was used for data collection, and STATA version 16 was used for data analysis. Bivariable logistic regression was conducted to identify the determinants of Intensive Care Unit delirium. Multivariable regression analysis was fitted to identify independent determinants of delirium in the intensive care unit. Illiteracy was associated with increased delirium risk (AOR: 4.60, 95% CI 2.44–9.75, p = 0.02), smoking (AOR: 2.58; 95% CI 1.80–7.17, p = 0.001), alcohol use (AOR: 3.84; 95% CI (3.46–11.18, p = 0.005), ketamine (AOR: 2.58; 95% CI 1.94–8.72, p = 0.03), and elevated serum creatinine levels (AOR; 2.78; 95% CI 2.07–7.87, p = 0.002) were identified as independent factors. Illiteracy, smoking, alcohol use, elevated creatinine levels, and the use of ketamine for sedation were the determinants of Intensive Care Unit delirium. Hence, attempts to reduce (stop) smoking, alcoholism, proper optimizations of the renal functions to maintain creatinine levels within normal range, and avoiding the use of ketamine for sedation may reduce the incidence of delirium in the intensive care unit patients.