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. Raben; Susanne Holman; Fleur Nooteboom; Carina Bethlehem; Julia ten Cate; Martijn Verkade; Lisa Mijzen; Janneke M. de Man-van Ginkel; Hester Vermeulen; Mark van den Boogaard

doi:10.1016/j.iccn.2020.102925

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 journal › Article › Academic › peer-review

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 language	English
Article number	102925
Number of pages	7
Journal	Intensive and Critical Care Nursing
Volume	61
DOIs	https://doi.org/10.1016/j.iccn.2020.102925
Publication status	Published - Dec 2020

Keywords

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

Access to Document

10.1016/j.iccn.2020.102925

Cite this

Berger, E., Wils, E.-J., Vos, P., van Santen, S., Koets, J., Slooter, A. J. C., van der Woude, M., Koopmans, M., Rinket, M. A., Hoiting, O., Hoogendoorn, E. E., Streefkerk, J. O., de Vreede, E. W., Riekerk, B., Simons, K. S., Toscano, E., Schoonderbeek, F. J., Hofstra, L. S., van den Oever, H. L. A., ... van den Boogaard, M. (2020). Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study. Intensive and Critical Care Nursing, 61, Article 102925. https://doi.org/10.1016/j.iccn.2020.102925

@article{731224c18c7e4e3a8ec9a6656e82032e,

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

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.",

keywords = "Critically ill, Delirium management, ICU, Prevalence, Risk factors, CRITICALLY-ILL PATIENTS, CONFUSION ASSESSMENT METHOD, VALIDATION, PAIN",

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

note = "Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",

year = "2020",

month = dec,

doi = "10.1016/j.iccn.2020.102925",

language = "English",

volume = "61",

journal = "Intensive and Critical Care Nursing",

issn = "0964-3397",

publisher = "Churchill Livingstone",

}

Berger, E, Wils, E-J, Vos, P, van Santen, S, Koets, J, Slooter, AJC, van der Woude, M, Koopmans, M, Rinket, MA, Hoiting, O, Hoogendoorn, EE, Streefkerk, JO, de Vreede, EW, Riekerk, B, Simons, KS, Toscano, E, Schoonderbeek, FJ, Hofstra, LS, van den Oever, HLA, Raben, AMTJ, Holman, S, Nooteboom, F, Bethlehem, C, ten Cate, J, Verkade, M, Mijzen, L, de Man-van Ginkel, JM, Vermeulen, H & van den Boogaard, M 2020, 'Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study', Intensive and Critical Care Nursing, vol. 61, 102925. https://doi.org/10.1016/j.iccn.2020.102925

TY - JOUR

T1 - Prevalence and management of delirium in intensive care units in the Netherlands

T2 - An observational multicentre study

AU - Berger, Elke

AU - Wils, Evert-Jan

AU - Vos, Piet

AU - van Santen, Susanne

AU - Koets, Jeroen

AU - Slooter, Arjen J. C.

AU - van der Woude, Meta

AU - Koopmans, Matty

AU - Rinket, Martin A.

AU - Hoiting, Oscar

AU - Hoogendoorn, Emma E.

AU - Streefkerk, Jorn O.

AU - de Vreede, Els W.

AU - Riekerk, Bea

AU - Simons, Koen S.

AU - Toscano, Eryk

AU - Schoonderbeek, F. Jeannette

AU - Hofstra, Lieuwe S.

AU - van den Oever, Huub L. A.

AU - Raben, Adrienne M. T. J.

AU - Holman, Susanne

AU - Nooteboom, Fleur

AU - Bethlehem, Carina

AU - ten Cate, Julia

AU - Verkade, Martijn

AU - Mijzen, Lisa

AU - de Man-van Ginkel, Janneke M.

AU - Vermeulen, Hester

AU - van den Boogaard, Mark

PY - 2020/12

Y1 - 2020/12

N2 - 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.

AB - 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.

KW - Critically ill

KW - Delirium management

KW - ICU

KW - Prevalence

KW - Risk factors

KW - CRITICALLY-ILL PATIENTS

KW - CONFUSION ASSESSMENT METHOD

KW - VALIDATION

KW - PAIN

U2 - 10.1016/j.iccn.2020.102925

DO - 10.1016/j.iccn.2020.102925

M3 - Article

C2 - 32868188

SN - 0964-3397

VL - 61

JO - Intensive and Critical Care Nursing

JF - Intensive and Critical Care Nursing

M1 - 102925

ER -