Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/56782 |
Resumo: | Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Hospital Copa D'Or. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Instituto de Doenças do Tórax. Rio de Janeiro, RJ, Brasil. |
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Serafim, Rodrigo B.Dal-Pizzol, FelipeSouza-Dantas, VicenteSoares, MarcioBozza, Fernando A.Póvoa, PedroLuiz, Ronir RaggioLapa-e-Silva, José R.Salluh, Jorge I. F.2023-01-31T10:39:12Z2023-01-31T10:39:12Z2022SERAFIM, Rodrigo B. et al. Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay. Journal of clinical medicine, v. 11, n. 22, p. 1-8, 2022.2077-0383https://www.arca.fiocruz.br/handle/icict/5678210.3390/jcm11226797engMDPIImpact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stayinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleInstituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Hospital Copa D'Or. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Instituto de Doenças do Tórax. Rio de Janeiro, RJ, Brasil.Universidade do Extremo Sul Catarinense. Programa de Pós-Graduação em Ciências da Saúde. Laboratório de Fisiopatologia experimental. Criciúma, SC, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Centro Hospitalar de Lisboa Ocidental. Hospital de São Francisco Xavier. Unidade de Cuidados Intensivos Polivalente. Lisboa, Portugal / Universidade Nova de Lisboa. NOVA Medical School. Lisboa, Portugal / OUH Odense University Hospital. Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology. Odense, Denmark.Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Instituto de Saúde Coletiva. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Instituto de Doenças do Tórax. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil.Despite recent advances in the field, the association between subsyndromal delirium (SSD) in the ICU and poor outcomes is not entirely clear. We performed a retrospective multicentric observational study analyzing mental status during the first 72 h of ICU stay. Of the 681 patients included, SSD occurred in 22.7%. Considering the worst cognitive assessment during the first 72 h, 233 (34%) patients had normal mental status, 124 (18%) patients had SSD and 324 (48%) patients had delirium or coma. SSD was not independently associated with an increased risk of death when compared with normal mental status (OR 95%IC 1.0 vs. 1.35 [0.73-1.49], p = 0.340), but was associated with a longer ICU LOS (7.0 (4-12) vs. 4 (3-8) days, p < 0.001). SSD patients who deteriorated to delirium or coma (21%) had a longer ICU LOS in comparison with those who improved or maintained mental status (8 (5-11) vs. 6 (4-8) days, p = 0.025), but did not have an increase in mortality. The main factors associated with the progression from SSD to delirium or coma were the use of mechanical ventilation, the use of intravenous benzodiazepines and a baseline APACHE II score > 23 points. Our findings support the association of SSD with increased ICU LOS, but not with ICU mortality. Monitoring the trajectory of SSD early at ICU admission can help to identify patients with increased risk of conversion from SSD to delirium or coma.ICUCognitive dysfunctionCritically illDeliriumSubsyndromal deliriuminfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALImpact_Fernando_Bozza_etal_2022.pdfImpact_Fernando_Bozza_etal_2022.pdfapplication/pdf422697https://www.arca.fiocruz.br/bitstream/icict/56782/2/Impact_Fernando_Bozza_etal_2022.pdf4a8d4a1bacb249caf585eb3fafe22716MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/56782/1/license.txt5a560609d32a3863062d77ff32785d58MD51icict/567822023-01-31 07:39:13.219oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-01-31T10:39:13Repositório Institucional da FIOCRUZ (ARCA) - 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dc.title.en_US.fl_str_mv |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay |
title |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay |
spellingShingle |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay Serafim, Rodrigo B. ICU Cognitive dysfunction Critically ill Delirium Subsyndromal delirium |
title_short |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay |
title_full |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay |
title_fullStr |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay |
title_full_unstemmed |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay |
title_sort |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay |
author |
Serafim, Rodrigo B. |
author_facet |
Serafim, Rodrigo B. Dal-Pizzol, Felipe Souza-Dantas, Vicente Soares, Marcio Bozza, Fernando A. Póvoa, Pedro Luiz, Ronir Raggio Lapa-e-Silva, José R. Salluh, Jorge I. F. |
author_role |
author |
author2 |
Dal-Pizzol, Felipe Souza-Dantas, Vicente Soares, Marcio Bozza, Fernando A. Póvoa, Pedro Luiz, Ronir Raggio Lapa-e-Silva, José R. Salluh, Jorge I. F. |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Serafim, Rodrigo B. Dal-Pizzol, Felipe Souza-Dantas, Vicente Soares, Marcio Bozza, Fernando A. Póvoa, Pedro Luiz, Ronir Raggio Lapa-e-Silva, José R. Salluh, Jorge I. F. |
dc.subject.en.en_US.fl_str_mv |
ICU Cognitive dysfunction Critically ill Delirium Subsyndromal delirium |
topic |
ICU Cognitive dysfunction Critically ill Delirium Subsyndromal delirium |
description |
Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Hospital Copa D'Or. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Instituto de Doenças do Tórax. Rio de Janeiro, RJ, Brasil. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2023-01-31T10:39:12Z |
dc.date.available.fl_str_mv |
2023-01-31T10:39:12Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
SERAFIM, Rodrigo B. et al. Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay. Journal of clinical medicine, v. 11, n. 22, p. 1-8, 2022. |
dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/56782 |
dc.identifier.issn.en_US.fl_str_mv |
2077-0383 |
dc.identifier.doi.none.fl_str_mv |
10.3390/jcm11226797 |
identifier_str_mv |
SERAFIM, Rodrigo B. et al. Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay. Journal of clinical medicine, v. 11, n. 22, p. 1-8, 2022. 2077-0383 10.3390/jcm11226797 |
url |
https://www.arca.fiocruz.br/handle/icict/56782 |
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eng |
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eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
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MDPI |
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MDPI |
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