March 17, 2014

Delirium increases long-term disability

Patients who suffer a longer duration of delirium in the intensive care unit are more likely to experience long-term disability after discharge.


Delirium – severe inattention and confusion – is common in intensive care unit (ICU) patients and is associated with longer hospital stays, higher mortality and long-term cognitive impairment. Nathan Brummel, M.D., MSCI, and colleagues now demonstrate that delirium duration is also associated with long-term disability among survivors of mechanical ventilation.

The investigators conducted a prospective cohort study among critically ill patients enrolled in a trial of a paired sedation and ventilator weaning strategy. They assessed survivors at 3 and 12 months after hospital discharge and found that longer duration of delirium in the ICU was associated with increased odds of newly acquired disability in the basic activities of daily living – such as bathing, dressing and feeding – and with worse motor-sensory function.

The results, reported in the February issue of Critical Care Medicine, add to a growing list of adverse outcomes associated with delirium and underscore the importance of monitoring for delirium in the ICU – and employing measures to prevent and treat it.

This research was supported by the National Institutes of Health (HL087738, AG031322, AG027472, TR000445, AG035117) and by the VA Clinical Science Research and Development Service.

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