Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study

Detalhes bibliográficos
Autor(a) principal: Rita Sofia Carneiro Martins
Data de Publicação: 2021
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://hdl.handle.net/10216/139746
Resumo: Purpose This study aims to analyze the occurrence of delirium in critically-ill older patients and to identify predictor factors for delirium. Methods This prospective study included critically-ill older patients admitted into level II units of Intensive Care Medicine Department of a University Hospital. Patients with Glasgow Coma Scale score ≤11, traumatic brain injury, terminal disease, history of psychosis, blindness/deafness or inability to understanding/speaking Portuguese were excluded. The Confusion Assessment Method-Short form (CAM-4) was used to delirium assessment. Results The final sample (n=105) had a median age of 80 years, being the majority female (56.2%), widowed (49.5%) and with complete primary education (53%). Through CAM-4, 36.2% of the patients had delirium. The delirium group presented more pre-existing cognitive decline (48.6% vs 19.6%, p=0.04) and severe dependency in instrumental activities of daily living (34.3% vs 14.8%, p=0.032), comparing to patients without delirium. The final multiple logistic regression model explained that patients with previous cognitive decline presented a higher risk for delirium (OR: 4.663, 95% CI: 1.055-20.599, p=0.042). Conclusion These findings corroborate previous studies, showing that cognitive decline is an independent predictor for delirium in older patients. This study is an important contribution for the knowledge regarding the predictor factors for delirium. The recognition of these factors will help to identify patients who are at high risk for this syndrome, and to implement an early screening and prevention strategies. However, further studies with larger samples, recruited from other clinical settings as well as analyzing other potential factors for delirium, will be needed.
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spelling Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort studyMedicina clínicaClinical medicinePurpose This study aims to analyze the occurrence of delirium in critically-ill older patients and to identify predictor factors for delirium. Methods This prospective study included critically-ill older patients admitted into level II units of Intensive Care Medicine Department of a University Hospital. Patients with Glasgow Coma Scale score ≤11, traumatic brain injury, terminal disease, history of psychosis, blindness/deafness or inability to understanding/speaking Portuguese were excluded. The Confusion Assessment Method-Short form (CAM-4) was used to delirium assessment. Results The final sample (n=105) had a median age of 80 years, being the majority female (56.2%), widowed (49.5%) and with complete primary education (53%). Through CAM-4, 36.2% of the patients had delirium. The delirium group presented more pre-existing cognitive decline (48.6% vs 19.6%, p=0.04) and severe dependency in instrumental activities of daily living (34.3% vs 14.8%, p=0.032), comparing to patients without delirium. The final multiple logistic regression model explained that patients with previous cognitive decline presented a higher risk for delirium (OR: 4.663, 95% CI: 1.055-20.599, p=0.042). Conclusion These findings corroborate previous studies, showing that cognitive decline is an independent predictor for delirium in older patients. This study is an important contribution for the knowledge regarding the predictor factors for delirium. The recognition of these factors will help to identify patients who are at high risk for this syndrome, and to implement an early screening and prevention strategies. However, further studies with larger samples, recruited from other clinical settings as well as analyzing other potential factors for delirium, will be needed.2021-06-232021-06-23T00:00:00Z2031-06-22T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttps://hdl.handle.net/10216/139746TID:203179099engRita Sofia Carneiro Martinsinfo:eu-repo/semantics/embargoedAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-29T16:12:44Zoai:repositorio-aberto.up.pt:10216/139746Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:39:06.162747Repositório 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 Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
title Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
spellingShingle Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
Rita Sofia Carneiro Martins
Medicina clínica
Clinical medicine
title_short Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
title_full Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
title_fullStr Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
title_full_unstemmed Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
title_sort Occurrence and predictors factors for delirium in critically-ill older patients: a prospective cohort study
author Rita Sofia Carneiro Martins
author_facet Rita Sofia Carneiro Martins
author_role author
dc.contributor.author.fl_str_mv Rita Sofia Carneiro Martins
dc.subject.por.fl_str_mv Medicina clínica
Clinical medicine
topic Medicina clínica
Clinical medicine
description Purpose This study aims to analyze the occurrence of delirium in critically-ill older patients and to identify predictor factors for delirium. Methods This prospective study included critically-ill older patients admitted into level II units of Intensive Care Medicine Department of a University Hospital. Patients with Glasgow Coma Scale score ≤11, traumatic brain injury, terminal disease, history of psychosis, blindness/deafness or inability to understanding/speaking Portuguese were excluded. The Confusion Assessment Method-Short form (CAM-4) was used to delirium assessment. Results The final sample (n=105) had a median age of 80 years, being the majority female (56.2%), widowed (49.5%) and with complete primary education (53%). Through CAM-4, 36.2% of the patients had delirium. The delirium group presented more pre-existing cognitive decline (48.6% vs 19.6%, p=0.04) and severe dependency in instrumental activities of daily living (34.3% vs 14.8%, p=0.032), comparing to patients without delirium. The final multiple logistic regression model explained that patients with previous cognitive decline presented a higher risk for delirium (OR: 4.663, 95% CI: 1.055-20.599, p=0.042). Conclusion These findings corroborate previous studies, showing that cognitive decline is an independent predictor for delirium in older patients. This study is an important contribution for the knowledge regarding the predictor factors for delirium. The recognition of these factors will help to identify patients who are at high risk for this syndrome, and to implement an early screening and prevention strategies. However, further studies with larger samples, recruited from other clinical settings as well as analyzing other potential factors for delirium, will be needed.
publishDate 2021
dc.date.none.fl_str_mv 2021-06-23
2021-06-23T00:00:00Z
2031-06-22T00:00:00Z
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