Clinical phenotypes of delirium in patients admitted to the cardiac intensive care unit
Background Limited data are available on clinical phenotype for delirium that occurs frequently among patients admitted to the cardiac intensive care unit (CICU). The objective of this study was to investigate the clinical pictures of delirium, and their association with clinical outcomes in CICU pa...
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| Veröffentlicht in: | PloS one 2022-09, Vol.17 (9), p.e0273965-e0273965 |
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| description | Background Limited data are available on clinical phenotype for delirium that occurs frequently among patients admitted to the cardiac intensive care unit (CICU). The objective of this study was to investigate the clinical pictures of delirium, and their association with clinical outcomes in CICU patients. Methods A total of 4,261 patients who were admitted to the CICU between September 1 2012 to December 31 2018 were retrospectively registered. Patients were excluded if they were admitted to the CICU for less than 24 hours or had missed data. Ultimately, 2,783 patients were included in the analysis. A day of delirium was defined as any day during which at least one CAM-ICU assessment was positive. The clinical risk factors of delirium were classified by the delirium phenotype, as follows; hypoxic, septic, sedative-associated, and metabolic delirium. Results The incidence of delirium was 24.4% at the index hospitalization in all CICU patients, and 22.6% within 7 days after CICU admission. The most common delirium phenotype was septic delirium (17.2%), followed by hypoxic delirium (16.8%). Multiple phenotypes were observed during most delirium days. Delirium most frequently occurred in patients with heart failure. Of all patients affected by delirium within 7 days, both ICU and hospital mortality significantly increased according to the combined number of delirium phenotypes. Conclusions Delirium occurred in a quarter of patients admitted to the modern CICU and was associated with increased in-hospital mortality. Therefore, more efforts are needed to reduce the clinical risk factors of delirium, and to prevent it in order to improve clinical outcomes in the CICU. |
| doi_str_mv | 10.1371/journal.pone.0273965 |
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| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2709311235</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A715961190</galeid><doaj_id>oai_doaj_org_article_ccf4cd3802fa49f29a405ed547706be1</doaj_id><sourcerecordid>A715961190</sourcerecordid><originalsourceid>FETCH-LOGICAL-c562t-c488fbc4c783dec4187b73752d812d8196f005f841ee9267e51246ee144556113</originalsourceid><addsrcrecordid>eNptkl2LEzEUhgdR3N3qPxAcEGRvWvOdyY2wFD8WFrxRvAxp5kybkiZjklnYf2-6HWUrXoSEk4f3fc_hNM0bjFaYSvxhH6cUjF-NMcAKEUmV4M-aS6woWQqC6PMn74vmKuc9Qpx2QrxsLqhAnGHSXTY_194FZ41vxx2EWB5GyG0c2h68S246tC60oykOQsmt6Q-uFOjbEtuyg9aa1DtjK1MgZHf_WIF2Cq68al4Mxmd4Pd-L5sfnT9_XX5d3377crm_ulpYLUpaWdd2wsczKjvZgGe7kRlLJSd_h41FiqKmHjmEARYQEjgkTAJgxzgXGdNG8PemOPmY9zyRrIpGiGBPKK3F7Ivpo9npM7mDSg47G6cdCTFttUnHWg7Z2YLanHSKDYWogyjDEoedMSiQ2cHT7OLtNmwP0tk4lGX8mev4T3E5v471WjKoavApczwIp_pogF31w2YL3JkCcTrkl5aimXzTv_kH_391MbU1twIUhVl97FNU3EnNVZ6RQpd4_oXZgfNnl6KfiYsjnIDuBNsWcEwx_e8NIH9fuTwh9XDs9rx39DTjHycQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2709311235</pqid></control><display><type>article</type><title>Clinical phenotypes of delirium in patients admitted to the cardiac intensive care unit</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Ko, Ryoung-Eun ; Kim, Sungeun ; Lee, Jihye ; Park, Sojin ; Bae, Daehwan ; Choi, Ki Hong ; Park, Taek Kyu ; Chung, Chi Ryang ; Yang, Jeong Hoon</creator><creatorcontrib>Ko, Ryoung-Eun ; Kim, Sungeun ; Lee, Jihye ; Park, Sojin ; Bae, Daehwan ; Choi, Ki Hong ; Park, Taek Kyu ; Chung, Chi Ryang ; Yang, Jeong Hoon</creatorcontrib><description>Background Limited data are available on clinical phenotype for delirium that occurs frequently among patients admitted to the cardiac intensive care unit (CICU). The objective of this study was to investigate the clinical pictures of delirium, and their association with clinical outcomes in CICU patients. Methods A total of 4,261 patients who were admitted to the CICU between September 1 2012 to December 31 2018 were retrospectively registered. Patients were excluded if they were admitted to the CICU for less than 24 hours or had missed data. Ultimately, 2,783 patients were included in the analysis. A day of delirium was defined as any day during which at least one CAM-ICU assessment was positive. The clinical risk factors of delirium were classified by the delirium phenotype, as follows; hypoxic, septic, sedative-associated, and metabolic delirium. Results The incidence of delirium was 24.4% at the index hospitalization in all CICU patients, and 22.6% within 7 days after CICU admission. The most common delirium phenotype was septic delirium (17.2%), followed by hypoxic delirium (16.8%). Multiple phenotypes were observed during most delirium days. Delirium most frequently occurred in patients with heart failure. Of all patients affected by delirium within 7 days, both ICU and hospital mortality significantly increased according to the combined number of delirium phenotypes. Conclusions Delirium occurred in a quarter of patients admitted to the modern CICU and was associated with increased in-hospital mortality. Therefore, more efforts are needed to reduce the clinical risk factors of delirium, and to prevent it in order to improve clinical outcomes in the CICU.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0273965</identifier><identifier>PMID: 36054128</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Analysis ; Biology and Life Sciences ; Cardiac patients ; Coma ; Congestive heart failure ; Coronary care units ; Critical care ; Delirium ; Development and progression ; Evaluation ; Extracorporeal membrane oxygenation ; Genotype & phenotype ; Health risks ; Heart failure ; Hypoxia ; Influence ; Intensive care ; Medical records ; Medicine and Health Sciences ; Mental disorders ; Mortality ; Patient outcomes ; Patients ; Phenotypes ; Risk analysis ; Risk factors ; Services ; Ventilators</subject><ispartof>PloS one, 2022-09, Vol.17 (9), p.e0273965-e0273965</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Ko et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Ko et al 2022 Ko et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c562t-c488fbc4c783dec4187b73752d812d8196f005f841ee9267e51246ee144556113</citedby><cites>FETCH-LOGICAL-c562t-c488fbc4c783dec4187b73752d812d8196f005f841ee9267e51246ee144556113</cites><orcidid>0000-0002-4464-8613 ; 0000-0001-8138-1367</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439246/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439246/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids></links><search><creatorcontrib>Ko, Ryoung-Eun</creatorcontrib><creatorcontrib>Kim, Sungeun</creatorcontrib><creatorcontrib>Lee, Jihye</creatorcontrib><creatorcontrib>Park, Sojin</creatorcontrib><creatorcontrib>Bae, Daehwan</creatorcontrib><creatorcontrib>Choi, Ki Hong</creatorcontrib><creatorcontrib>Park, Taek Kyu</creatorcontrib><creatorcontrib>Chung, Chi Ryang</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><title>Clinical phenotypes of delirium in patients admitted to the cardiac intensive care unit</title><title>PloS one</title><description>Background Limited data are available on clinical phenotype for delirium that occurs frequently among patients admitted to the cardiac intensive care unit (CICU). The objective of this study was to investigate the clinical pictures of delirium, and their association with clinical outcomes in CICU patients. Methods A total of 4,261 patients who were admitted to the CICU between September 1 2012 to December 31 2018 were retrospectively registered. Patients were excluded if they were admitted to the CICU for less than 24 hours or had missed data. Ultimately, 2,783 patients were included in the analysis. A day of delirium was defined as any day during which at least one CAM-ICU assessment was positive. The clinical risk factors of delirium were classified by the delirium phenotype, as follows; hypoxic, septic, sedative-associated, and metabolic delirium. Results The incidence of delirium was 24.4% at the index hospitalization in all CICU patients, and 22.6% within 7 days after CICU admission. The most common delirium phenotype was septic delirium (17.2%), followed by hypoxic delirium (16.8%). Multiple phenotypes were observed during most delirium days. Delirium most frequently occurred in patients with heart failure. Of all patients affected by delirium within 7 days, both ICU and hospital mortality significantly increased according to the combined number of delirium phenotypes. Conclusions Delirium occurred in a quarter of patients admitted to the modern CICU and was associated with increased in-hospital mortality. Therefore, more efforts are needed to reduce the clinical risk factors of delirium, and to prevent it in order to improve clinical outcomes in the CICU.</description><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Cardiac patients</subject><subject>Coma</subject><subject>Congestive heart failure</subject><subject>Coronary care units</subject><subject>Critical care</subject><subject>Delirium</subject><subject>Development and progression</subject><subject>Evaluation</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Genotype & phenotype</subject><subject>Health risks</subject><subject>Heart failure</subject><subject>Hypoxia</subject><subject>Influence</subject><subject>Intensive care</subject><subject>Medical records</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Phenotypes</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Services</subject><subject>Ventilators</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptkl2LEzEUhgdR3N3qPxAcEGRvWvOdyY2wFD8WFrxRvAxp5kybkiZjklnYf2-6HWUrXoSEk4f3fc_hNM0bjFaYSvxhH6cUjF-NMcAKEUmV4M-aS6woWQqC6PMn74vmKuc9Qpx2QrxsLqhAnGHSXTY_194FZ41vxx2EWB5GyG0c2h68S246tC60oykOQsmt6Q-uFOjbEtuyg9aa1DtjK1MgZHf_WIF2Cq68al4Mxmd4Pd-L5sfnT9_XX5d3377crm_ulpYLUpaWdd2wsczKjvZgGe7kRlLJSd_h41FiqKmHjmEARYQEjgkTAJgxzgXGdNG8PemOPmY9zyRrIpGiGBPKK3F7Ivpo9npM7mDSg47G6cdCTFttUnHWg7Z2YLanHSKDYWogyjDEoedMSiQ2cHT7OLtNmwP0tk4lGX8mev4T3E5v471WjKoavApczwIp_pogF31w2YL3JkCcTrkl5aimXzTv_kH_391MbU1twIUhVl97FNU3EnNVZ6RQpd4_oXZgfNnl6KfiYsjnIDuBNsWcEwx_e8NIH9fuTwh9XDs9rx39DTjHycQ</recordid><startdate>20220902</startdate><enddate>20220902</enddate><creator>Ko, Ryoung-Eun</creator><creator>Kim, 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phenotypes of delirium in patients admitted to the cardiac intensive care unit</title><author>Ko, Ryoung-Eun ; Kim, Sungeun ; Lee, Jihye ; Park, Sojin ; Bae, Daehwan ; Choi, Ki Hong ; Park, Taek Kyu ; Chung, Chi Ryang ; Yang, Jeong Hoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c562t-c488fbc4c783dec4187b73752d812d8196f005f841ee9267e51246ee144556113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Cardiac patients</topic><topic>Coma</topic><topic>Congestive heart failure</topic><topic>Coronary care units</topic><topic>Critical care</topic><topic>Delirium</topic><topic>Development and progression</topic><topic>Evaluation</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Genotype & phenotype</topic><topic>Health risks</topic><topic>Heart failure</topic><topic>Hypoxia</topic><topic>Influence</topic><topic>Intensive care</topic><topic>Medical records</topic><topic>Medicine and Health Sciences</topic><topic>Mental disorders</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Phenotypes</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Services</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ko, Ryoung-Eun</creatorcontrib><creatorcontrib>Kim, Sungeun</creatorcontrib><creatorcontrib>Lee, Jihye</creatorcontrib><creatorcontrib>Park, Sojin</creatorcontrib><creatorcontrib>Bae, Daehwan</creatorcontrib><creatorcontrib>Choi, Ki Hong</creatorcontrib><creatorcontrib>Park, Taek Kyu</creatorcontrib><creatorcontrib>Chung, Chi Ryang</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior 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admitted to the cardiac intensive care unit</atitle><jtitle>PloS one</jtitle><date>2022-09-02</date><risdate>2022</risdate><volume>17</volume><issue>9</issue><spage>e0273965</spage><epage>e0273965</epage><pages>e0273965-e0273965</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Background Limited data are available on clinical phenotype for delirium that occurs frequently among patients admitted to the cardiac intensive care unit (CICU). The objective of this study was to investigate the clinical pictures of delirium, and their association with clinical outcomes in CICU patients. Methods A total of 4,261 patients who were admitted to the CICU between September 1 2012 to December 31 2018 were retrospectively registered. Patients were excluded if they were admitted to the CICU for less than 24 hours or had missed data. Ultimately, 2,783 patients were included in the analysis. A day of delirium was defined as any day during which at least one CAM-ICU assessment was positive. The clinical risk factors of delirium were classified by the delirium phenotype, as follows; hypoxic, septic, sedative-associated, and metabolic delirium. Results The incidence of delirium was 24.4% at the index hospitalization in all CICU patients, and 22.6% within 7 days after CICU admission. The most common delirium phenotype was septic delirium (17.2%), followed by hypoxic delirium (16.8%). Multiple phenotypes were observed during most delirium days. Delirium most frequently occurred in patients with heart failure. Of all patients affected by delirium within 7 days, both ICU and hospital mortality significantly increased according to the combined number of delirium phenotypes. Conclusions Delirium occurred in a quarter of patients admitted to the modern CICU and was associated with increased in-hospital mortality. Therefore, more efforts are needed to reduce the clinical risk factors of delirium, and to prevent it in order to improve clinical outcomes in the CICU.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>36054128</pmid><doi>10.1371/journal.pone.0273965</doi><orcidid>https://orcid.org/0000-0002-4464-8613</orcidid><orcidid>https://orcid.org/0000-0001-8138-1367</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Biology and Life Sciences Cardiac patients Coma Congestive heart failure Coronary care units Critical care Delirium Development and progression Evaluation Extracorporeal membrane oxygenation Genotype & phenotype Health risks Heart failure Hypoxia Influence Intensive care Medical records Medicine and Health Sciences Mental disorders Mortality Patient outcomes Patients Phenotypes Risk analysis Risk factors Services Ventilators |
| title | Clinical phenotypes of delirium in patients admitted to the cardiac intensive care unit |
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