Lynn McNicoll, MD, FRCPC, Department of Internal Medicine, Brown University School of Medicine, Providence, RI.
Delirium in older hospitalized persons in non-critical care settings is associated with higher morbidity, mortality, and worse long-term outcomes. Delirium in critically ill persons is a growing field of research. This article presents recent research indicating a high frequency of delirium in critical care. Several studies have shown that delirium in critical care is associated with poor short-term as well as long-term outcomes, including increased length of stay, persistent cognitive deficits, and hospital and one-year mortality. Further research on strategies to prevent delirium in critical care may improve short- and long-term outcomes.
Key words: delirium, critical care, aging, outcomes, older adults.
Yoanna Skrobik, MD, FRCP(C), Director, Adult Critical Care Training Program, Université de Montreal; Associate Professor, Faculty of Medicine, Université de Montreal, Montreal, QC.
Delirium is a morbid and common complication in the critically ill patient. Its recognition is made more difficult by the inability to interview the intubated patient, and by the presence of drugs and confounding comorbidities. Delirium screening (described with the ICDSC and the CAM-ICU) with tools specifically designed for the acute care setting can help the nurse or clinician identify its presence. Risk factors for delirium in the critical care setting differ from those described in other populations. Treatment is currently empiric.
Key words: delirium, critical care, outcomes, intensive care, screening.
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