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Prevalence and Risk Factors of Pediatric Delirium in Critically Ill Children: A Study Using Cornell Assessment of

Muhammad Nashit1, Anwar Ul Haque2, Sadiq Mirza3

  • 1Department of Clinical Affairs, ChildLife Foundation, Karachi, Sindh, Pakistan.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|October 20, 2025
PubMed

Insights

Pediatric delirium affects nearly a quarter of critically ill children. Key risk factors include comorbidities, developmental delay, and certain medications, highlighting the need for early detection using the Cornell Assessment of Pediatric Delirium.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neuroscience
  • Clinical Assessment Tools

Background:

  • Delirium is a common complication in critically ill children.
  • Early detection and management are crucial for improving outcomes.
  • The Cornell Assessment of Pediatric Delirium (CAPD)-revised is a validated tool for this purpose.

Purpose of the Study:

  • To determine the prevalence of delirium in critically ill children.
  • To identify associated risk factors for pediatric delirium.
  • To evaluate the utility of the CAPD-revised tool in a real-world setting.

Main Methods:

  • A descriptive cross-sectional study was conducted with 201 critically ill children (1 month-14 years).
  • Delirium was assessed twice daily for three days using the CAPD-revised tool.
  • A score of ≥9 on the CAPD-revised was considered diagnostic for delirium.

Main Results:

  • Delirium was identified in 24.9% of the pediatric intensive care unit patients.
  • Significant risk factors included comorbidities (OR=3.45), developmental delay (OR=5.12), benzodiazepine use (OR=2.89), antiepileptic use (OR=2.67), high-flow oxygen (OR=2.31), and mechanical ventilation (OR=3.12).
  • The mean age of affected children was 5.14 years, with 61.7% being male.

Conclusions:

  • Nearly one-quarter of critically ill children experienced delirium.
  • Comorbidities, developmental delay, sedative use, and advanced respiratory support were key risk factors.
  • The CAPD-revised tool is valuable for routine screening and early management of pediatric delirium.
Abstract

Keywords:
DeliriumPediatric critical carePediatric intensive care unit

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