Substance Withdrawal Syndrome
Conditions
Keywords
intensive care unit, delirium, substance withdrawal
Brief summary
Investigators are seeking to determine the impact of recent alcohol, smoking or psychotropic drug use prior to intensive care unit (ICU) admission on incidence of delirium and sedation requirements. Study design: A prospective observational study, in a medical ICU of a tertiary university hospital. Methods: For all new ICU admissions, a 1-page questionnaire including Alcohol Use Disorders Identification Test (AUDIT-C), smoking history and prior medication use was given to the patient or closest family members. Delirium was assessed by trained ICU nurses using Intensive Care Delirium Screening Checklist and Richmond Agitation-Sedation Scale.
Interventions
OTHERAUDIT-C
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including AUDIT-C about his/her alcohol behavior during last year and will be categorized into two groups: Those with AUDIT-C\>4 versus AUDIT-C of 4 or below.
OTHERSmoking history
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including smoking history during last year and will be categorized into two groups: Current smoker versus ex- or never smoker (we also recorded smoking pack-years to distinguish heavy smokers)
OTHERPrior psychotropic medication use
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including psychotropic medication use prior admission to ICU and will be categorized into two groups: Those who use psychotropic medication versus those who do not use psychotropic medication.
Sponsors
Seoul National University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who are older than 18 years of age * New patients admitted to medical ICU for the 1st time during their stay in hospital
Exclusion criteria
* Had history of stroke or other primary neurologic disease * GCS ≤ 8 prior to ICU admission * Transferred from other ICU (except for emergency ICU stay which is limited to less than 36 hours) * Not registered within 24 hours after admission * Refused to participate * If comatous state persists * Delirium assessment is not possible due to newly developed neurologic disease, such as cerebral infarction * Medical ICU stay less than 24 hours * Readmission to medical ICU
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Delirium during ICU stay | From date of ICU admission until the date of ICU discharge, whichever came first, assessed up to 3 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ICU length of stay | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months | — |
| Mortality | From date of ICU admission until the date of death, assessed up to 3 months | Death in MICU |
| Maximal doses of dexmedetomidine | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months | — |
| Cumulative dose of dexmedetomidine | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months | Cumulative dose of dexmedetomidine during the patient's MICU stay |
| Cumulative dose of midazolam | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months | Cumulative dose of midazolam during the patient's MICU stay |
Countries
South Korea
Outcome results
None listed