Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study

Elke Berger*, Evert-Jan Wils, Piet Vos, Susanne van Santen, Jeroen Koets, Arjen J. C. Slooter, Meta van der Woude, Matty Koopmans, Martin A. Rinket, Oscar Hoiting, Emma E. Hoogendoorn, Jorn O. Streefkerk, Els W. de Vreede, Bea Riekerk, Koen S. Simons, Eryk Toscano, F. Jeannette Schoonderbeek, Lieuwe S. Hofstra, Huub L. A. van den Oever, Adrienne M. T. J. RabenSusanne Holman, Fleur Nooteboom, Carina Bethlehem, Julia ten Cate, Martijn Verkade, Lisa Mijzen, Janneke M. de Man-van Ginkel, Hester Vermeulen, Mark van den Boogaard

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objectives: This study aimed to determine the prevalence, risk factors of delirium and current practice of delirium management in intensive care units of various levels of care.

Research methodology/design: Prospective multicentre cohort study.

Setting: In all adult patients admitted to one of the participating intensive care units on World Delirium Awareness Day 2018, delirium point and period prevalence rates were measured between ICU admission and seven days after the index day.

Results: In total, 28 (33%) Dutch intensive care units participated in this study. Point-prevalence was 23% (range 41), and period-prevalence was 42% (range 70). University intensive care units had a significantly higher delirium point-prevalence compared with non-university units (26% vs.15%, p = 0.02). No signif-icant difference were found in period prevalence (50% vs. 39%, p = 0.09). Precipitating risk factors, infection and mechanical ventilation differed significantly between delirium and non-delirium patients. No differences were observed for predisposing risk factors. A delirium protocol was present in 89% of the ICUs. Mean delirium assessment compliance measured was 84% (+/- 19) in 14 units and estimated 59% (+/- 29) in the other 14.

Conclusion: Delirium prevalence in Dutch intensive care units is substantial and occurs with a large variation, with the highest prevalence in university units. Precipitating risk factors were more frequent in patients with delirium. In the majority of units a delirium management protocol is in place. (C) 2020 Elsevier Ltd. All rights reserved.

Original languageEnglish
Article number102925
Number of pages7
JournalIntensive and Critical Care Nursing
Volume61
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Critically ill
  • Delirium management
  • ICU
  • Prevalence
  • Risk factors
  • CRITICALLY-ILL PATIENTS
  • CONFUSION ASSESSMENT METHOD
  • VALIDATION
  • PAIN

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