DELIRIUM INCIDENCE AND OUTCOMES IN MECHANICALLY VENTILATED ICU PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
Delirium, Mechanical Ventilation, Intensive Care Unit, CAM-ICU, Mortality, Critical Care.
Abstract
Background: Delirium is a frequent neuropsychiatric complication among critically ill patients receiving mechanical ventilation in the intensive care unit (ICU). It is associated with adverse clinical outcomes, including prolonged mechanical ventilation, increased length of stay, and higher mortality. Early detection and management of delirium may improve patient outcomes and reduce healthcare burden.
Objectives: To determine the incidence of delirium and evaluate its impact on clinical outcomes among mechanically ventilated ICU patients admitted to a tertiary care hospital.
Methods: This prospective observational study was conducted in the Intensive Care Unit of Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, from March 2020 to October 2022. A total of 120 adult patients requiring mechanical ventilation for more than 24 hours were enrolled. Delirium was assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU). Demographic characteristics, comorbidities, severity of illness, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and mortality were recorded and analyzed.
Results: Among the 120 mechanically ventilated patients included in the study, 46 patients developed delirium, yielding an incidence of 38.3%. Patients with delirium had significantly longer duration of mechanical ventilation (9.4 ± 3.6 vs. 5.8 ± 2.7 days, p<0.001), prolonged ICU stay (12.7 ± 4.8 vs. 7.3 ± 3.1 days, p<0.001), and increased hospital stay (18.9 ± 6.2 vs. 12.5 ± 4.9 days, p<0.001) compared to non-delirious patients. Mortality was also significantly higher in the delirium group (32.6% vs. 16.2%, p=0.036).
Conclusion: Delirium is a common complication among mechanically ventilated ICU patients and is associated with significantly worse clinical outcomes, including prolonged mechanical ventilation, extended ICU and hospital stay, and increased mortality. Routine delirium screening and implementation of preventive strategies should be integral components of ICU care to improve patient outcomes.
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Dr. (Major) Sourabh Kumar
Assistant Professor, Intensive Care, Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Kriti Prasad
Consultant & Senior IVF Specialist, Seeds of Innocens, Ranchi, Jharkhand, India.
Dr. Prabha Rashmi Lakra
Senior Resident, Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Vashist Raj
Junior Resident, Santosh Medical College, Ghaziabad, Uttar Pradesh, India.
Dr. Sarita Hansda
Junior Resident, Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Shio Priye
Professor, Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Dr. Ladhu Lakra
Professor & Head, Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
