Reduction of Neuro Check Intervals in Traumatic Brain Injury Patients is Associated with Lower Delirium Risk

Area of Science:

• Neuroscience
• Critical Care Medicine
• Trauma Surgery

Background:

• Delirium is a frequent complication in traumatic brain injury (TBI) patients.
• Sleep disruption, often caused by frequent neurologic assessments, contributes to delirium development.
• Hourly neurologic examinations (Q1 neuro checks) in the ICU disrupt TBI patients' sleep.

Purpose of the Study:

• To investigate the association between the duration of Q1 neuro checks and delirium incidence in ICU TBI patients.
• To determine if shorter Q1 neuro check durations reduce delirium diagnoses without increasing complications.

Main Methods:

• Retrospective cohort analysis of 153 ICU TBI patients from December 2021 to July 2023.
• Patients were divided into groups based on Q1 neuro check duration (<24 hours vs. >24 hours).
• Multivariate logistic and linear regression models analyzed delirium, mortality, and ICU length of stay (LOS).

Main Results:

• Multivariate analysis revealed that Q1 neuro checks >24 hours significantly increased the risk of delirium (OR 9.73), mortality (OR 17.11), and ICU LOS (2.57 days).
• No significant difference in overall complications was observed between the groups.
• Univariate analysis showed no significant difference in delirium rates.

Conclusions:

• Extended Q1 neuro checks (>24 hours) in TBI patients are associated with increased delirium, mortality, and ICU LOS.
• Shorter Q1 neuro check durations did not lead to increased complications.
• Further research with larger cohorts is needed to confirm findings and identify optimal Q1 neuro check durations for TBI patients.