The Influence Of Early Assessment And Intervention For Delirium On The Outcome Of The Patients Of Emergency Intensive Care Unit

ObjectiveTo determine the influence of early assessment and intervention for delirium on the outcome of the patients in emergency intensive care unit.MethodsOne hundred and fifty patients sequentially admitted in the emergency intensive care unit of the second hospital of Lanzhou university from September 2014 to March 2015 were enrolled this study with rules and regulations of the medical ethic committee on Research Human Care at the the second hospital of Lanzhou university. The patients were randomly divided into experimental group and control group by random number table.The patients who is transferred from EICU in 24h,or died within 24h,or expected to be unawakened (such as craniocerebral trauma,diffuse axonal injury, brain stem hemorrhage,large area cerebral infarction),and with the deaf history,dementia,psychosis,chronic mental retardation and other neurological diseases were also excluded.With the patients admission immediately in CAM-ICU group,CAM-ICU was used to assess the occurrence rate of delirium for patients admitted at 9:00 to 11:00 am and 8:00 to 10:00 pm,respectively.The patients in control group were assessed only in the presence of clinical obvious symptoms of delirium. Both groups in the emergency ICU were given the same support therapy, including actively treating the primary disease,controlling infection,maintaining water and electrolyte balance, nutritional support and other support therapy;minimizing limb braking and encouraging early activities;When delirium occurred,patients were immediately given interventions.Then to compare the occurence rate of deliriun,the mechanical ventilation time,the ICU length of hospital stay,hospitalization expenses and 28 days mortality between both groups.Result1.The incidence of critical patient delirium was 34.67% in the second hospital of lanzhou university,similar to previous reports.2.Compared with patients without delirium, delirium patients had a longer length of hospital stay and mechanical ventilation time,the hospitalization costs was more, the 28 days mortality was higher(P<0.05).3.Compared with the control group, the CAM-ICU patients had significantly shorter hospital stay and mechanical ventilation time(P<0.05),the hospitalization expenses and 28 days mortality compared with the control group had a downward trend, but had no statistical difference(P>0.05).ConclusionsThis study found that the incidence of delirium of the Emergency ICU is 34.67%;Delirium patients in ICU had longer hospital stay, mechanical ventilation and more hospitalization costs,and 28 days mortality is higher;Daily delirium assessment and early intervention, wrer helpful to early diagnosis of delirium and can improve the delirium diagnosis of Emergency ICU, can reduce in-hospital time, mechanical ventilation time, but the hospitalization expenses and 28 days mortality had no statistical difference between both group.