Delirium
Conditions
Keywords
Critical illness, ICU, Delirium, prediction, Observational
Brief summary
Delirium is frequently observed among critically ill patients and is associated with detrimental outcomes. Currently, no evidence-based prevention or treatment exists for delirium, and especially, the inability to identify effective preventive measures of delirium has increased the focus on identifying patients with a high risk of delirium through prediction models. Two prediction models have been developed to estimate the risk of delirium in ICU patients: the prediction model for delirium (PRE-DELIRIC) and the early prediction model for delirium (E-PRE-DELIRIC). These robust and well-calibrated prediction models have the potential of assisting in identifying patients with the highest risk for delirium and thereby to focusing preventive strategies on the most vulnerable group. However further validation is needed in a Danish population.
Detailed description
Adult ICU patients admitted to the participating ICUs in the Region Zealand are included according to eligibility. Eligible patients will be assessed with E-PREDELIRIC at admission to the ICU and PREDELIRIC 24h after admission to the ICU. Patients will be screened twice daily with CAM-ICU until ICU discharge, death, transferal to non-participating ICU or for a maximum observation period of 14 days. Central screening via EPIC PDM and registration in central database (REDCap, ZUH) by the principal investigator. The following are registered: Age, sex, history of cognitive impairment, history of alcohol abuse, admission category, urgent admission, mean arterial blood pressure at the time of ICU admission, use of corticosteroids, respiratory failure, Blood Urea Nitrogen/Carbamide, APACHE-II score, administered morphine does, use of sedatives, metabolic acidosis, coma, presence of infection, delirium status by CAM-ICU, time of ventilation, length of ICU and hospital stay, mortality.
Interventions
OTHERPrediction models
The prediction scores are validated by the CAM-ICU scores up to 14 days after ICU admission.
Sponsors
Zealand University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 110 Years
Healthy volunteers
No
Inclusion criteria
* Acute admission to an ICU AND * Age \> 18 of years
Exclusion criteria
* Total admittance to the ICU less than 24 hours * Delirium assessment nonapplicable (hearing or visual disabilities, language barriers, or mentally incompetent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| AUROC for PRE-DELIRIC | Duration of the study, november 2021 to september 2022 | Area Under the Receiver Operating Characteristics (AUROC) for PRE-DELIRIC |
| AUROC for E-PRE-DELIRIC | Based on 14 days of ICU admission | Area Under the Receiver Operating Characteristics (AUROC) for E-PRE-DELIRIC |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 30-days mortality | 30 days efter ICU admission | Dead or alive at day 30 after ICU admission |
| Time on ventilator | 14 days after ICU admission | Days in need of mechanical ventilation up to 14 days of ICU admission |
| ICU length of stay | 30 days after ICU admission | Days in the ICU up to 30 days |
| Hospital length of stay | 30 days after ICU admission | Days in the hospital up to 30 days after ICU admission |
Countries
Denmark
Outcome results
None listed