Delirium in Trauma Patients: Prevalence and Predictors.

Area of Science:

• Trauma critical care medicine
• Neuroscience
• Gerontology

Background:

• Delirium is linked to higher mortality, morbidity, costs, and cognitive issues post-discharge.
• Existing research predominantly covers non-trauma patients on mechanical ventilation in ICUs.
• Understanding delirium in trauma patients is crucial for improving outcomes.

Purpose of the Study:

• To assess the prevalence of delirium in trauma patients.
• To identify predictors of delirium in trauma patients.
• To examine delirium in both intensive and intermediate care units.

Main Methods:

• Utilized the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for screening.
• Included 215 trauma patients in academic medical center ICUs and intermediate care units.
• Applied exclusion criteria for brain injury, psychosis, cognitive impairment, and sensory deficits.

Main Results:

• 24% of trauma patients screened positive for delirium.
• Delirium prevalence was higher in the ICU (36%) than intermediate care (11%).
• Mechanical ventilation (OR 4.73), older age (53.4 vs 44 years), antipsychotic use, APACHE III scores, and RASS scores predicted delirium.

Conclusions:

• Delirium is present in trauma patients across ICU and intermediate care settings, even without mechanical ventilation.
• Delirium prevention strategies should be considered for all trauma patients.
• Inpatient location and ventilation status do not preclude delirium risk in trauma patients.