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Impact of Delirium on Prolonged Intensive Care Unit Stay in Critically Ill Older Patients
1Wonkwang University Hospital, Iksan, South Korea.
Purpose:
This study aimed to investigate the impact of delirium on prolonged intensive care unit (ICU) stay in critically ill older patients.
Methods:
This prospective descriptive correlational study included 198 consecutive older patients who were admitted to three ICUs at a tertiary hospital in South Korea. Delirium was assessed using the Korean Nursing Delirium Screening Scale, and a prolonged ICU stay was defined as eight days or longer. Multivariable logistic regression analysis was performed to evaluate the impact of delirium on prolonged ICU stay in critically ill older patients.
Results:
In critically ill older patients, the prevalence of delirium and prolonged ICU stay were 37.8% and 34.3%, respectively. Older patients with delirium during their ICU stay had a significantly higher risk of prolonged ICU stay compared to those without delirium (odds ratio [OR] = 5.21, p < .001, 95% confidence interval [CI]: 2.22-12.19). We suggest that delirium is a strong predictor of prolonged ICU stay in critically ill older patients.
Conclusions:
Enhancing ICU nurses' knowledge of delirium in critically ill older patients can facilitate the early recognition of patients at risk upon admission. Therefore, establishing an early and systematic delirium screening system in ICUs is essential for promptly identifying high-risk patients and delivering individualized, evidence-based delirium care. Such efforts may contribute to reducing prolonged ICU stay and improving clinical outcomes in critically ill older patients.
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