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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Exploring the Relationship Between Neighborhood Disadvantage and ICU Delirium Characteristics.

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Geographic disadvantage was not linked to ICU delirium duration or severity. However, Black race was associated with longer delirium and greater severity, indicating a need to study social determinants of health in delirium.

Keywords:
deliriumintensive care unitneighborhood disadvantageolder adults

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Area of Science:

  • Critical Care Medicine
  • Neuroscience
  • Public Health

Background:

  • Delirium is a serious neuropsychiatric syndrome in critically ill patients, linked to poor outcomes and mortality.
  • Geographic disadvantage has been associated with delirium, but its impact on intensive care unit (ICU) patients is unclear.

Purpose of the Study:

  • To investigate the relationship between geographic disadvantage and delirium characteristics in adult ICU patients.
  • To explore if area deprivation index (ADI) influences delirium duration and severity.

Main Methods:

  • Secondary analysis of data from the Pharmacologic Management of Delirium clinical trial.
  • Included 326 adult ICU patients diagnosed with delirium using the Confusion Assessment Method for the ICU (CAM-ICU).
  • Geographic disadvantage assessed using the Area Deprivation Index (ADI); outcomes included delirium duration (delirium- and coma-free days) and severity (CAM-ICU-7 scores).

Main Results:

  • No association was found between ADI quintiles and delirium duration or severity.
  • No association was found between ADI quintiles and discharge home rates or in-hospital mortality.
  • Black race was significantly associated with longer delirium duration and greater severity in the first week of ICU stay.

Conclusions:

  • Geographic disadvantage did not correlate with delirium duration or severity in this ICU cohort.
  • Observed association between race and delirium characteristics underscores the importance of socioeconomic factors in delirium research.
  • Further investigation into social determinants of health and their impact on delirium is warranted.