全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Effects of Coronavirus Disease 2019 and Frailty on Delirium in the Intensive Care Unit: A Propensity Score Analysis

DOI: 10.4236/ojanes.2023.132003, PP. 23-31

Keywords: COVID-19, Delirium, Frailty, Intensive Care Unit, SARS-CoV-2

Full-Text   Cite this paper   Add to My Lib

Abstract:

Purpose: The association between frailty and delirium has emerged as a research topic. Neurological symptoms have been reported among patients with coronavirus disease 2019 (COVID-19), but its effects on delirium remain unclear. This study aimed to compare the incidence of delirium between patients with COVID-19 and those without COVID-19, and to evaluate the impact of COVID-19 and frailty on delirium. Methods: This retrospective study included patients aged ≥ 20 years who were admitted to our intensive care unit (ICU) between January 2020 and February 2022. An inverse probability of treatment weighting using stabilized inverse propensity scores was adopted to minimize bias. After patient demographics were adjusted, the incidence of delirium, assessed using the Confusion Assessment Method for ICU, was compared between patients with COVID-19 and those without COVID-19. The effects of COVID-19 and the Clinical Frailty Scale score on delirium were analyzed by adjusting some covariates, including the sequential organ failure assessment (SOFA) score, using a generalized estimating equation. Results: Among 260 eligible patients, 226 patients were included. The weighted incidence of delirium was 56.9% and 61.9% in patients with and without COVID-19, respectively (p = 0.67). The generalized estimating equation revealed that the odds ratios (95% confidence interval) for COVID-19, the CFS score, and the SOFA score were 1.49 (0.62 - 3.57), 1.46 (1.11 - 1.91), and 1.22 (1.10 - 1.36), respectively. Conclusion: CFS and SOFA scores on ICU admission may be associated with delirium, with no significant difference between patients with COVID-19 and those without COVID-19.

References

[1]  Roy, M., Rivest, M.P., Namian, D. and Moreau, N. (2019) The Critical Reception of the DSM-5: Towards a Typology of Audiences. Public Understanding of Science, 28, 932-948.
https://doi.org/10.1177/0963662519868969
[2]  Rood, P., Huisman-de Waal, G., Vermeulen, H., Schoonhoven. L., Pickkers, P., et al. (2018) Effect of Organisational Factors on the Variation in Incidence of Delirium in Intensive Care Unit Patients: A Systematic Review and Meta-Regression Analysis. Australian Critical Care, 31, 180-187.
https://doi.org/10.1016/j.aucc.2018.02.002
[3]  Kotfis, K., Marra, A. and Ely, E.W. (2018) ICU Delirium—A Diagnostic and Therapeutic Challenge in the Intensive Care Unit. Anaesthesiology Intensive Therapy, 50, 160-167.
https://doi.org/10.5603/AIT.a2018.0011
[4]  Kooken, R.W.J., van den Berg, M., Slooter, A.J.C., Pop-Purceleanu, M. and van den Boogaard, M. (2021) Factors Associated with a Persistent Delirium in the Intensive Care Unit: A Retrospective Cohort Study. Journal of Critical Care, 66, 132-137.
https://doi.org/10.1016/j.jcrc.2021.09.001
[5]  Gracie, T.J., Caufield-Noll, C., Wang, N.Y. and Sieber, F.E. (2021) The Association of Preoperative Frailty and Postoperative Delirium: A Meta-Analysis. Anesthesia & Analgesia, 133, 314-323.
https://doi.org/10.1213/ANE.0000000000005609
[6]  Darvall, J.N., Bellomo, R., Paul, E., Bailey, M., Young, P.J., et al. (2021) Routine Frailty Screening in Critical Illness: A Population-Based Cohort Study in Australia and New Zealand. Chest, 160, 1292-1303.
https://doi.org/10.1016/j.chest.2021.05.049
[7]  Koh, J., Shah, S.U., Chua, P.E.Y., Gui, H. and Pang, J. (2020) Epidemiological and Clinical Characteristics of Cases During the Early Phase of COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Frontiers in Medicine (Lausanne), 7, 295.
https://doi.org/10.3389/fmed.2020.00295
[8]  Helms, J., Kremer, S. and Meziani F. (2020) More on Neurologic Features in Severe SARS-CoV-2 Infection. Reply. The New England Journal of Medicine, 382, e110.
https://doi.org/10.1056/NEJMc2015132
[9]  Alkeridy, W.A., Almaghlouth, I., Alrashed, R., Alayed, K., Binkhamis, K., et al. (2020) A Unique Presentation of Delirium in a Patient with Otherwise Asymptomatic COVID-19. Journal of the American Geriatrics Society, 68, 1382-1384.
https://doi.org/10.1111/jgs.16536
[10]  Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., et al. (2020) Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurology, 77, 683-690.
https://doi.org/10.1001/jamaneurol.2020.1127
[11]  Shao, S.C., Lai, C.C., Chen, Y.H., Chen, Y.C., Hung, M.J., et al. (2021) Prevalence, Incidence and Mortality of Delirium in Patients with COVID-19: A Systematic Review and Meta-Analysis. Age Ageing, 50, 1445-1453.
https://doi.org/10.1093/ageing/afab103
[12]  Jäckel, M., Aicher, N., Biever, P.M., Heine, L., Bemtgen, X., et al. (2021) Delirium in Critically Ill Patients with and without COVID-19: A Retrospective Analysis. Journal of Clinical Medicine, 10, 4412.
https://doi.org/10.3390/jcm10194412
[13]  Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, Meneilly, G.S., Knip, A. and Tessier, D. (2013) Diabetes in the Elderly. The Canadian Journal of Diabetes, 37, S184-S190.
https://doi.org/10.1016/j.jcjd.2013.01.045
[14]  Vincent, J.L., de Mendonça, A., Cantraine, F., Moreno, R., Takala, J., et al. (1998) Use of the SOFA Score to Assess the Incidence of Organ Dysfunction/Failure in Intensive Care Units: Results of a Multicenter, Prospective Study. Working Group on “Sepsis-Related Problems” of the European Society of Intensive Care Medicine. Critical Care Medicine, 26, 1793-1800.
https://doi.org/10.1097/00003246-199811000-00016
[15]  Sessler, C.N., Gosnell, M.S., Grap, M.J., Brophy, G.M., O’Neal, P.V., et al. (2002) The Richmond Agitation-Sedation Scale: Validity and Reliability in Adult Intensive Care Unit Patients. American Journal of Respiratory and Critical Care Medicine, 166, 1338-1344.
https://doi.org/10.1164/rccm.2107138
[16]  Ely, E.W., Inouye, S.K., Bernard, G.R., Gordon, S., Francis, J., et al. (2001) Delirium in Mechanically Ventilated Patients: Validity and Reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). JAMA, 286, 2703-2710.
https://doi.org/10.1001/jama.286.21.2703
[17]  Austin, P.C. (2009) Using the Standardized Difference to Compare the Prevalence of a Binary Variable between Two Groups in Observational Research. Communications in Statistics—Simulation and Computation, 38, 1228-1234.
https://doi.org/10.1080/03610910902859574
[18]  Fried, L.P., Ferrucci, L., Darer, J., Williamson, J.D. and Anderson, G. (2004) Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care. The Journals of Gerontology Series A Biological Sciences and Medical Sciences, 59, 255-263.
https://doi.org/10.1093/gerona/59.3.M255
[19]  Williamson, C.A., Faiver, L., Nguyen, A.M., Ottenhoff, L. and Rajajee V. (2022) Incidence, Predictors and Outcomes of Delirium in Critically Ill Patients with COVID-19. Neurohospitalist, 12, 31-37.
https://doi.org/10.1177/19418744211034815
[20]  Rahimi-Bashar, F., Abolhasani, G., Manouchehrian, N., Jiryaee, N., Vahedian-Azimi, A., et al. (2021) Incidence and Risk Factors of Delirium in the Intensive Care Unit: A Prospective Cohort. BioMed Research International, 2021, Article ID: 6219678.
https://doi.org/10.1155/2021/6219678
[21]  Klein, R.S. (2022) Mechanisms of Coronavirus Infectious Disease 2019-Related Neurologic Diseases. Current Opinion in Neurology, 35, 392-398.
https://doi.org/10.1097/WCO.0000000000001049

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133