Research Of Morbidity And Relative Factors Of Delirium In Intensive Care Unit

Domestic and international studies have shown that the incidence of delirium in the intensive care unit is high, approximately 16% -89%, However, the delirium often missed. Foreign literature shows that the clinical recognition of delirium rate was 30%, with at least 33% to 95% of delirium were missed. So far, domestic researchers on the epidemiology of delirium is rare. The multicenter epidemiological studies of ICU delirium have not been reported, especially, the delirium screening of ICU patients is not performed, and undergoing treatment is also less. In 2013, the sedation treatment guidelines published by society of Critical Care Medicine (SCCM) and the Chinese Medical Association of Critical Care Medicine Branch have emphasized all ICU patients receiving mechanical ventilation or critical patients need to monitor the level of sedation and simultaneous monitor the delirium. This study is based on the incidence and related risk factors of delirium in the northeastern Sichuan region hospital intensive care unit.Objectives:To investigate the incidence of patients with delirium in ICU; To explore the related risk factors of delirium occurring;Subjects and Methods:Collected clinical data of critically ill patients in ICU during March 2014-September 2014, general information on the survey; disease severity assessment (APACHE II score); Disease Survey。 analgesic drugs Use the time of ICU admission, use of mechanical ventilation, with or without constraints; and to incorporate the use of CAM-ICU patients DICU diagnosis. Describing the incidence of ICU delirium and establishing a database and adopt SPSS 18.0 statistical software package for univariate analysis, whichever is statistically significant (P<0.05) variables do multivariate logistic regression analysis.A cross-sectional survey research methods, Collected clinical data of critically ill patients in ICU during March 2014-September 2014, collect relevant information to complete four questionnaires:general information questionnaire, delirium diagnosis table, disease severity assessment form (acute physiology and chronic health evaluation), the treatment of disease status questionnaires in which general information questionnaire survey and treatment of disease status is homemade table, delirium diagnosis used in the tables ICU confusion assessment Method (CAM-ICU) of the patients included in ICU delirium (DICU) diagnosis. The incidence of ICU delirium description, time of occurrence, the establishment of a database, and using SPSS 18.0 statistical software package for the risk factors of delirium occurrence univariate analysis, whichever is statistically significant (P<0.05) variables, stepwise Act on behalf of the multivariate Logistic regression analysis.Results:1. Through the 130 patients (male 84 cases, female 46 cases) who were DICU diagnosis,30 cases patients had delirium, the rate was 23.07%.2. Through the univariate analysis of delirium group and the comparison group of non-delirium, risk factors DICU occurrence:past history (P= 0.02), APACHE Ⅱ score (P= 0.00), use of sedative and analgesic drugs (P= 0.00), use of mechanical ventilation (P= 0.00), disease diagnosis (P= 0.01) and surgery(P= 0.00). 3. Through multivariate logistic regression analysis, the results show the use of mechanical ventilation OR 7.14(95% CI 2.44-20.86) past history OR 3.19(95% CI 1.09-9.34);APACHE II score OR 1.22(95% CI 1.10-1.35); surgery OR 3.41(95% CI 1.09-10.71).In conclusion:In this study, the incidence of delirium was 23.07%. This is related to the incidence of reported domestic delirium similar data. Determine the risk factors for delirium by univariate analysis:mechanical ventilation, surgery, past history, APACHE II score, the use of sedation drugs, disease diagnosis.Logistic regression analysis show risk by univariate analysis of the patients increased the risk of delirium 7.14; Patients with history surgery increased 3.41 for delirium occurrence; The risk factor of delirium on patients with past history is higher than patients without past history for about 3.19; APACHE II score increased 1 point for each occurrence of delirium increased 1.22. Prompt medical attention delirium risk factors for clinical populations, early screening, early diagnosis and early intervention to reduce the incidence of delirium.