Publication: Delirium in Critically ill Patients in a Tertiary Care Centre in Western Region of Nepal
Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Delirium affects a significant proportion of critically ill patients admitted in hospital.
It is associated with various adverse outcomes. Despite its enormous prognostic
significance it tends to be underdiagnosed. There is a dearth of studies on risk
factors of delirium in our setting.
Objectives
The main objectives of this study was to find out the prevalence, rate of non
recognition and risk factors associated with delirium in hospitalized critically ill
patients.
Methods
A hospital based cross-sectional study was carried out. Data was collected using
a predesigned semi-structured proforma and Intensive care delirium screening
checklist was used to screen for delirium in patients admitted in various wards of
Manipal teaching hospital, Pokhara, Nepal.
Results
Ninety five cases were included in the analysis. The mean age of study group
was 58.9 ± 19.1 years. Delirium was present in 15/95 cases and it was not
recognized by treating physician in about one third of cases. Odds ratio (OR) was
statistically significantly increased in patients with history of stroke (OR=4.484 95%
CI=1.0896;18.459), alcohol use (OR=10.792 95% CI=2.906;40.072), smoking (OR=
4.836 95% CI= 1.411;16.576), use of restraint (OR=17.143 95% CI=4.401;66.766),
nasogastric tube placement (OR= 7.731 95% CI=2.348;25.452) and use of Foley’s
catheter (OR=12.000 95% CI= 3.072;46.877).
Conclusion
About 16% of critically ill patients were found to be delirious. In about one third of
the cases delirium was not recognized. Both patient related and iatrogenic factors
may increase the risk of delirium in hospitalized critically ill patients.
KEY WORDS
Critical care, delirium, non-recognition
Description
Thapa P,1 Chakraborty PK,1 Khattri JB,1 Ramesh K,1 Sharma P2
1Department of Psychiatry
Manipal College of Medical Sciences
Phulbari-11, Pokhara, Nepal
2Mental Disease Treatment and Rehabilitation Centre
Attarkhel, Kathmandu