Document Type

Journal Article

Date of this Version

1-1-2009

Publication Source

Chest

Volume

135

Issue

1

Start Page

18

Last Page

25

DOI

10.1378/chest.08-1456

Abstract

BACKGROUND: We previously noted that older adults admitted to surgical ICUs (SICUs) are at high risk for delirium. In the current study, we describe the association between the presence of delirium and complications in older SICU patients, and describe the association between delirium occurring in the SICU and functional ability and discharge placement for older patients.

METHODS: Secondary analysis of prospective, observational, cohort study. Subjects were 114 consecutive patients >or= 65 years old admitted to a surgical critical care service. All subjects underwent daily delirium and sedation/agitation screening during hospitalization. Outcomes prospectively recorded included SICU complication development, discharge location, and functional ability (as measured by the Katz activities of daily living instrument).

RESULTS: Nearly one third of older adults (31.6%) admitted to an SICU had a complication during ICU stay. There was a strong association between SICU delirium and complication occurrence (p = 0.001). Complication occurrence preceded delirium diagnosis for 16 of 20 subjects. Subjects with delirium in the SICU were more likely to be discharged to a place other than home (61.3% vs 20.5%, p < 0.0001) and have greater functional decline (67.7% vs 43.6%, p = 0.023) than nondelirious subjects. After adjusting for covariates including severity of illness and mechanical ventilation use, delirium was found to be strongly and independently associated with greater odds of being discharged to a place other than home (odds ratio, 7.20; 95% confidence interval, 1.93 to 26.82).

CONCLUSIONS: Delirium in older surgical ICU patients is associated with complications and an increased likelihood of discharge to a place other than home.

Copyright/Permission Statement

© 2009. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

Activities of Daily Living, Aged, Aged, 80 and over, Cohort Studies, Critical Care, Delirium, Female, Health Status, Hospitalization, Humans, Male, Recovery of Function, Retrospective Studies, Risk Factors, Thoracic Diseases, Treatment Outcome

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Date Posted: 08 July 2016

This document has been peer reviewed.