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Published on: April 11, 2019
Predictors of electroconvulsive therapy postictal delirium
Irving M Reti1, Aparna Krishnan2, Adam Podlisky2
1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Psychosomatics
|July 23, 2013
Summary
Longer electroconvulsive therapy (ECT) seizures predict postictal delirium in the postanesthesia care unit. This finding aids staff in managing patients after ECT.
Area of Science:
- Neuroscience
- Psychiatry
- Anesthesiology
Background:
- Postictal delirium is a frequent complication of electroconvulsive therapy (ECT).
- Delirium post-ECT poses risks to patients and healthcare staff in the postanesthesia care unit (PACU).
- Predictors of postictal delirium remain largely unknown.
Purpose of the Study:
- To identify patient and electroconvulsive therapy (ECT) treatment variables that predict postictal delirium.
- To investigate the relationship between ECT parameters and the occurrence of postictal delirium.
Main Methods:
- Prospective monitoring of postictal delirium using the Confusion Assessment Method for the Intensive Care Unit in 96 patients undergoing their first ECT treatment.
- Retrospective chart review for patient and treatment variables.
- Development of a multiple logistic regression model to identify significant predictors.
Main Results:
- Seizure length was identified as a statistically significant predictor of postictal delirium (p = 0.003).
- No other patient or treatment variables demonstrated predictive value for postictal delirium.
Conclusions:
- Extended electroconvulsive therapy (ECT) seizure duration increases the risk of postictal delirium in the PACU after the initial treatment.
- PACU staff can utilize seizure length information to anticipate and manage postictal delirium effectively.
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