Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care Setting: An Observational Multicenter Study.

Journal: Critical care research and practice

Volume: 2015

Issue: 

Year of Publication: 2015

Affiliated Institutions:  Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box , Kampala, Uganda. Department of Internal Medicine, Mulago Hospital Complex, Mulago Hill, P.O. Box , Kampala, Uganda. Department of Clinical Epidemiology and Biostatistics, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box , Kampala, Uganda. Department of Psychiatry, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box , Kampala, Uganda.

Abstract summary 

Aim. Delirium is common among mechanically ventilated patients in the intensive care unit (ICU). There are little data regarding delirium among mechanically ventilated patients in Africa. We sought to determine the burden of delirium and associated factors in Uganda. Methods. We conducted a multicenter prospective study among mechanically ventilated patients in Uganda. Eligible patients were screened daily for delirium using the confusional assessment method (CAM-ICU). Comparisons were made using t-test, chi-squares, and Fisher's exact test. Predictors were assessed using logistic regression. The level of statistical significance was set at P < 0.05. Results. Of 160 patients, 81 (51%) had delirium. Median time to onset of delirium was 3.7 days. At bivariate analysis, history of mental illness, sedation, multiorgan dysfunction, neurosurgery, tachypnea, low mean arterial pressure, oliguria, fevers, metabolic acidosis, respiratory acidosis, anaemia, physical restraints, marital status, and endotracheal tube use were significant predictors. At multivariable analysis, having a history of mental illness, sedation, respiratory acidosis, higher PEEP, endotracheal tubes, and anaemia predicted delirium. Conclusion. The prevalence of delirium in a young African population is lower than expected considering the high mortality. A history of mental illness, anaemia, sedation, endotracheal tube use, and respiratory acidosis were factors associated with delirium.

Authors & Co-authors:  Kwizera Arthur A Nakibuuka Jane J Ssemogerere Lameck L Sendikadiwa Charles C Obua Daniel D Kizito Samuel S Tumukunde Janat J Wabule Agnes A Nakasujja Noeline N

Study Outcome 

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Statistics
Citations :  Ely E. W., Inouye S. K., Bernard G. R., et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) The Journal of the American Medical Association. 2001;286(21):2703–2710. doi: 10.1001/jama.286.21.2703.
Authors :  9
Identifiers
Doi : 491780
SSN : 2090-1305
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
Egypt