Delirium in the Pediatric Cardiac Intensive Care Unit and Use of a Language Other than English

This study aimed to characterize the relationship between the use of a language other than English (LOE) and the prevalence of delirium in the pediatric cardiac intensive care unit (CICU), hypothesizing that patients from families who use an LOE would have a higher prevalence of delirium compared to those from English-speaking families. This was a retrospective cohort study at a quaternary-care, free-standing children's hospital CICU. Children admitted to the CICU between January 1, 2017, and July 31, 2023 with documented delirium screening scores were included. The primary outcome was the presence of delirium, assessed using the Cornell Assessment of Pediatric Delirium (CAP-D) score, with scores ≥ 9 indicating delirium. Language was recorded in the electronic health record and categorized as English, Spanish, or language other than English or Spanish (LOES). Covariates included age, sex, length of stay, developmental delay, use of mechanical ventilation, use of physical restraints, receipt of vasoactive medications, and caregiver presence. Among 1865 patients with CAP-D scores, 25.6% (477 patients) experienced delirium. Neither Spanish-speaking [adjusted OR (aOR) 1.43, 95% CI 0.92-2.22] nor LOES patients (aOR 0.73, 95% CI 0.33-1.60) demonstrated higher odds of delirium. Established risk factors for delirium, including age, length of stay, and mechanical ventilation, were associated with increased delirium risk. Inconsistent caregiver presence at bedside was associated with higher odds of delirium (aOR 2.37, 95% CI 1.76-3.18). In this CICU cohort, there was no significant association between the use of an LOE and delirium in the CICU. There is a strong, independent relationship between inconsistent caregiver presence and delirium.