Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study

Detalhes bibliográficos
Autor(a) principal: Mariz, José
Data de Publicação: 2013
Outros Autores: Santos, Nadine Correia, Afonso, Hugo, Rodrigues, Pedro L., Faria, António, Sousa, Nuno, Teixeira, Jorge
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/1822/24199
Resumo: We are thankful to the staff at the EDIMCU of Hospital de Braga.
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spelling Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective studyEmergency departmentIntermediate care unitsShort stay unitsHigh dependency unitsDeliriumConfusion assessment methodLength of stayOsmolarityScience & TechnologyWe are thankful to the staff at the EDIMCU of Hospital de Braga.Background Identification of delirium in emergency departments (ED) is often underestimated; within EDs, studies on delirium assessment and relation with patient outcome in Intermediate Care Units (IMCU) appear missing in European hospital settings. Here we aimed to determine delirium prevalence in an EDIMCU (Hospital de Braga, Braga, Portugal) and assessed routine biochemical parameters that might be delirium indicators. Methods The study was prospective and observational. Sedation level was assessed via the Richmond Agitation-Sedation Scale and delirium status by the Confusion Assessment Method for the ICU. Information collected included age and gender, admission type, Charlson Comorbidity Index combined condition score (Charlson score), systemic inflammatory response syndrome criteria (SIRS), biochemical parameters (blood concentration of urea nitrogen, creatinine, hemoglobin, sodium and potassium, arterial blood gases, and other parameters as needed depending on clinical diagnosis) and EDIMCU length of stay (LOS). Statistical analyses were performed as appropriate to determine if baseline features differed between the ‘Delirium’ and ‘No Delirium’ groups. Multivariate logistic regression was performed to assess the effect of delirium on the 1-month outcome. Results Inclusion and exclusion criteria were met in 283 patients; 238 were evaluated at 1-month for outcome follow-up after EDIMCU discharge (“good” recovery without complications requiring hospitalization or institutionalization; “poor” institutionalization in permanent care-units/assisted-living or death). Delirium was diagnosed in 20.1% patients and was significantly associated with longer EDIMCU LOS. At admission, Delirium patients were significantly older and had significantly higher blood urea, creatinine and osmolarity levels and significantly lower hemoglobin levels, when compared with No Delirium patients. Delirium was an independent predictor of increased EDIMCU LOS (odds ratio 3.65, 95% CI 1.97-6.75) and poor outcome at 1-month after discharge (odds ratio 3.51, CI 1.84-6.70), adjusted for age, gender, admission type, presence of SIRS criteria, Charlson score and osmolarity at admission. Conclusions In an EDIMCU setting, delirium was associated with longer LOS and poor outcome at1-month post-discharge. Altogether, findings support the need for delirium screening and management in emergency settings.NCS is supported by the post-doctoral fellowship UMINHO/BPD/013/2011 by the European Commission (FP7) “SwitchBox” Project (Contract HEALTH-F2-2010-259772).BioMed Central (BMC)Universidade do MinhoMariz, JoséSantos, Nadine CorreiaAfonso, HugoRodrigues, Pedro L.Faria, AntónioSousa, NunoTeixeira, Jorge2013-012013-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/24199eng1471-227X10.1186/1471-227X-13-223360089http://dx.doi.org/10.1186%2F1471-227X-13-2info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:43:34Zoai:repositorium.sdum.uminho.pt:1822/24199Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T19:41:04.021726Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
title Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
spellingShingle Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
Mariz, José
Emergency department
Intermediate care units
Short stay units
High dependency units
Delirium
Confusion assessment method
Length of stay
Osmolarity
Science & Technology
title_short Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
title_full Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
title_fullStr Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
title_full_unstemmed Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
title_sort Risk and clinical-outcome indicators of delirium in an emergency department intermediate care unit (EDIMCU) : an observational prospective study
author Mariz, José
author_facet Mariz, José
Santos, Nadine Correia
Afonso, Hugo
Rodrigues, Pedro L.
Faria, António
Sousa, Nuno
Teixeira, Jorge
author_role author
author2 Santos, Nadine Correia
Afonso, Hugo
Rodrigues, Pedro L.
Faria, António
Sousa, Nuno
Teixeira, Jorge
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade do Minho
dc.contributor.author.fl_str_mv Mariz, José
Santos, Nadine Correia
Afonso, Hugo
Rodrigues, Pedro L.
Faria, António
Sousa, Nuno
Teixeira, Jorge
dc.subject.por.fl_str_mv Emergency department
Intermediate care units
Short stay units
High dependency units
Delirium
Confusion assessment method
Length of stay
Osmolarity
Science & Technology
topic Emergency department
Intermediate care units
Short stay units
High dependency units
Delirium
Confusion assessment method
Length of stay
Osmolarity
Science & Technology
description We are thankful to the staff at the EDIMCU of Hospital de Braga.
publishDate 2013
dc.date.none.fl_str_mv 2013-01
2013-01-01T00:00:00Z
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.uri.fl_str_mv http://hdl.handle.net/1822/24199
url http://hdl.handle.net/1822/24199
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1471-227X
10.1186/1471-227X-13-2
23360089
http://dx.doi.org/10.1186%2F1471-227X-13-2
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central (BMC)
publisher.none.fl_str_mv BioMed Central (BMC)
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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