Understanding delirium in critical care: A longitudinal observational study

Objectives To evaluate the incidence, motor subtypes, risk factors, and clinical outcome of delirium in the intensive care unit (ICU). Material and Methods This is a Longitudinal observational study design on a cohort of consecutive ICU admissions of a tertiary care hospital. The confusion assessment method-ICU and Richmond Agitation-Sedation Scale (RASS) were used to diagnose and categorize into motor subtypes of delirium, respectively. Risk variables and outcomes of delirium were compared with those of a control group. Results This study found 49 (24.75%) out of 198 patients who developed delirium. Incidence of the hypoactive subtype of delirium was highest (59.18%). Several predisposing risk factors were identified as increasing the risk of delirium, including older age, pre-existing cognitive impairment, history of mental illness, hearing impairment and alcohol use. Among precipitating factors, anemia, hypoalbuminemia, abnormalities in serum sodium levels and total bilirubin were associated with delirium. Additionally, delirium-affected patients had poorer outcomes in terms of mortality and lengthier ICU stays. Conclusion With a higher incidence in the ICU, Delirium becomes a serious yet preventable condition. The risk of delirium is associated with some predisposing and precipitating factors. If well investigated and managed, delirium can be reversible.