Point Prevalence of Delirium and Its Subtypes in the Patients Admitted with Acute Coronary Syndrome in Cardiac ICU and Its Impact on Mortality

  • Lalarukh Taimoor National Institute of Cardiovascular Diseases, Sukkur Pakistan
  • Komal Baloch National Institute of Cardiovascular Diseases, Sukkur Pakistan
  • Urwah Ikhlaq National Institute of Cardiovascular Diseases, Sukkur Pakistan
  • Jawed Abubaker National Institute of Cardiovascular Diseases, Sukkur Pakistan
  • Imran Ansari National Institute of Cardiovascular Diseases, Sukkur Pakistan
  • Nawal Salah Ud Din National Institute of Cardiovascular Diseases, Sukkur Pakistan
  • Musa Khan National Institute of Cardiovascular Diseases, Sukkur Pakistan
Keywords: Acute coronary syndromes, CAM-ICU, Mortality., Delirium

Abstract

Objective: To measure the point prevalence of delirium in the patients admitted to the cardiac ICU with acute coronary syndromes, with particular attention to the most commonly noted delirium and the impact on ICU mortality and length of ICU stay.

Study Design: Prospective cohort study.

Place and Study Duration: National Institute of Cardiovascular Diseases, Karachi Pakistan, from Mar and Jul 2021.

Methodology: Consecutive adult patients with age >18 years admitted to the cardiac ICU after acute coronary syndromes were assessed for delirium using the confusion assessment method (CAM)-ICU tool and Richmond agitation sedation score (>-3). The types of delirium were also assessed.

Results: 201 patients were enrolled, half of patients with ST-elevation MI (51.2%) and shock (45.8%). Delirium was identified in 71 (35.3%) patients, 30 (42.2%) had hypoactive delirium and 41 (57.7%) had hyperactive delirium. In multivariable regression, independent risk factors for delirium were: sepsis 3.19 (1.15-8.87), uremia 4.12 (1.18-14.46), mechanical ventilation 7.58 (1.2-47.99), and non-invasive ventilation 8.55 (2.9-25.2). Overall mortality was 35 (17.4%); 27/71 (38%) vs. 8/130 (6.2%); p 0.001 in patients with and without delirium, respectively. In multivariable regression, delirium was an independent risk factor for mortality at 7.12 (2.16-2.23). The mean ICU stay was 7.772.36 days vs. 3.91.44 days; p 0.001 for patients with and without delirium.

Conclusion: The deleterious effect of delirium in terms of higher morbidity and mortality cannot be overemphasised. Hypoactive delirium is as common as the hyperactive type, with the same mortality risk. Assessment for delirium is mandatory for all patients admitted..............

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Published
2022-04-29
How to Cite
Taimoor, L., Baloch, K., Ikhlaq, U., Abubaker, J., Ansari, I., Ud Din, N., & Khan, M. (2022). Point Prevalence of Delirium and Its Subtypes in the Patients Admitted with Acute Coronary Syndrome in Cardiac ICU and Its Impact on Mortality. PAFMJ, 72(2), 408-13. https://doi.org/10.51253/pafmj.v72i2.7444
Section
Original Articles