Chávez PJP, Sánchez VLD

Language: Spanish
References: 22
Page: 64-69
PDF size: 73.80 Kb.

ABSTRACT

Background: Several studies using different methodologies have reported an incidence of delirium between 16% and 83% in hospitalized patients in intensive care units (ICU). Out of patients that develop delirium 30% present hyperactive delirium, 24% hypoactive delirium and 46% a combination of both. In Mexico there is no statistics for that, nor of its effect in the evolution of patients.
Objectives: To determine the incidence and impact that hyperactive delirium has on morbi-mortality of patients in ICUs participating in the study.
Places: 18 ICUs of different public hospitals in Mexico City.
Design. Descriptive, comparative, longitudinal, prospective, multicentric, interinstitutional study in a cohort of one year.
Subjects: 4,587 patients were included; 85 of them were disqualified due to incomplete information. Methods. Demographic, clinical variables, scales of severity of the disease (APACHE II, Brussels), use of resources (NEMS) and mortality were collected. The population under study was divided into two groups: Group A, patients without hyperactive delirium, and Group B, patients with hyperactive delirium. Hyperactive delirium was defined as the necessity of immobilization in a stretcher and/or the use of haloperidol. The statistical analysis consisted of bivariate and multivariate analyses, considering significant a p ‹ 0.05 using the statistical package SPSS v. 13.
Results: Incidence of hyperactive delirium in this population was 17.7%. In Group B male patients predominated. There were no differences in age or education between groups. Group B was more severely ill on arrival at ICUs and remained so during their stay, developing a higher comorbidity and consuming more resources than Group A. Furthermore, Group B presented a higher expected mortality for APACHE II.
Conclusions: The incidence detected in this study is within the interval reported in literature. The hyperactive delirium was associated, in this study with more severity of the illness on arrival, higher comorbidity acquired in ICUs, higher consumption of resources and mortality in relation to what was expected.

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