Predicting factors of delirium in a medical intensive care unit
Keywords:
delirium, intubation, anemia, acidosis, hypoalbuminemiaAbstract
This descriptive study aimed to investigate the associations and predictors of delirium in the medical intensive care unit. The selected factors included age, anemia, metabolic acidosis, endotracheal intubation, and hypoalbuminemia. A retrospective study was conducted using data from all patients admitted to the medical intensive care unit of Ramathibodi Hospital between January 1, 2020, and December 31, 2021. The research instruments included a personal data record form, which consisted of personal data, health data, and information on factors related to delirium development, as well as the clinical outcomes of delirium using the Confusional Assessment Method for the ICU (CAM-ICU) assessment form. Data were analyzed using descriptive statistics, including the point-biserial correlation and Cramer's V coefficient, according to the characteristics of the variables. Binomial logistic regression analysis was then used to predict the occurrence of delirium.
The results of the study found that patients with older age, acidosis, hypoalbuminemia, and intubation were significantly associated with the development of delirium. However, there was no statistically significant association with anemia. Acidosis is most related to the onset of a delirium episode. Using binomial logistic regression, it was determined that the combined variables could predict the probability of exhibiting delirium by 27.9% (Nagelkerke R2=.279, p <.001). Acidosis was the most common predictive factor associated with the occurrence of delirium, followed by patients with intubation. The findings of this study highlight the significance of implementing appropriate approaches to prevent delirium in this patient group. Furthermore, in the intensive care unit, delirium, particularly hypoactive delirium, should be evaluated and monitored because this patient is asymptomatic and challenging to diagnose and treat.
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