Delirium: Cognitive, Functionality, and Quality of Life Outcomes in Critically Ill Patients

There is scarce evidence of the impact of delirium on the post-ICU outcomes of critically ill patients. This study assessed the effect of delirium on cognitive function, functionality, and quality of life after three months from discharge in critically ill patients.

A nested case-control study was realized from April to September 2018. The prevalence of delirium and its association with mortality was assessed, and the alterations in cognition, functionality, and quality of life in survivors of critical illness three months after discharge from the ICU.

81 patients were included and evaluated with the CAM-ICU; 43 were defined as cases. The prevalence of delirium was 26%, and the mortality of patients with and without delirium was 35.4% vs. 10%, respectively. In the follow-up, the delirium group showed lower scores in the MMSE (p<0.01), with a specific decline in the subdomains of orientation, calculation, and language/praxis compared with the control group. The delirium group showed a decreased score in the SF-36, with a significant decline in social function, emotional role, and mental health (p<0.05). There were no differences observed in functionality measured by the PGC-IADL.

Education strategies are required to increase delirium awareness in ICU teams. Support from a mental health interdisciplinary team is needed to guide the preventive and rehabilitation interventions for post-ICU patients.