Abstract:
RATIONALE:Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. PURPOSE:To develop and validate a model based on data available at ICU admission to predict delirium development during a patient's complete ICU stay and to determine the predictive value of this model in relation to the time of delirium development. METHODS:Prospective cohort study in 13 ICUs from seven countries. Multiple logistic regression analysis was used to develop the early prediction (E-PRE-DELIRIC) model on data of the first two-thirds and validated on data of the last one-third of the patients from every participating ICU. RESULTS:In total, 2914 patients were included. Delirium incidence was 23.6%. The E-PRE-DELIRIC model consists of nine predictors assessed at ICU admission: age, history of cognitive impairment, history of alcohol abuse, blood urea nitrogen, admission category, urgent admission, mean arterial blood pressure, use of corticosteroids, and respiratory failure. The area under the receiver operating characteristic curve (AUROC) was 0.76 [95% confidence interval (CI) 0.73-0.77] in the development dataset and 0.75 (95% CI 0.71-0.79) in the validation dataset. The model was well calibrated. AUROC increased from 0.70 (95% CI 0.67-0.74), for delirium that developed <2 days, to 0.81 (95% CI 0.78-0.84), for delirium that developed >6 days. CONCLUSION:Patients' delirium risk for the complete ICU length of stay can be predicted at admission using the E-PRE-DELIRIC model, allowing early preventive interventions aimed to reduce incidence and severity of ICU delirium.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Wassenaar A,van den Boogaard M,van Achterberg T,Slooter AJ,Kuiper MA,Hoogendoorn ME,Simons KS,Maseda E,Pinto N,Jones C,Luetz A,Schandl A,Verbrugghe W,Aitken LM,van Haren FM,Donders AR,Schoonhoven L,Pickkers Pdoi
10.1007/s00134-015-3777-2subject
Has Abstractpub_date
2015-06-01 00:00:00pages
1048-56issue
6eissn
0342-4642issn
1432-1238journal_volume
41pub_type
杂志文章,多中心研究abstract::Changes in the inspiratory flow rate of mechanically ventilated patients can affect arterial oxygenation. Although the mechanism producing this alteration is not certain, one possible mechanism is a change in ventilation inhomogeneity. This study was performed to determine if the inspiratory flow setting would affect ...
journal_title:Intensive care medicine
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journal_title:Intensive care medicine
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,评审
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journal_title:Intensive care medicine
pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
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journal_title:Intensive care medicine
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Intensive care medicine
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journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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更新日期:2012-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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