ORIGINAL ARTICLE
Year : 2022 | Volume
: 12 | Issue : 4 | Page : 190--196
Early onset delirium incidence and risk factors in hematology oncology patients admitted to the intensive care unit: A retrospective cohort study
Rachel C Klosko1, Joshua R Arnold2, Claire V Murphy2, Jessica Brimmer2, Natalie Hagy3, Matthew C Exline4, Eric McLaughlin5, Jessica L Elefritz2
1 Department of Pharmacy Practice, Binghamton University School of Pharmacy and Pharmaceutical Sciences, Johnson City, NY, The United States of America
2 Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio, The United States of America
3 College of Pharmacy, The Ohio State University, Columbus, Ohio, The United States of America
4 Division of Pulmonary Diseases, Critical Care Medicine, and Sleep, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, The United States of America
5 Center for Biostatistics, The Ohio State University, Columbus, Ohio, The United States of America
Correspondence Address:
Dr. Jessica L Elefritz
410 W 10th Ave, 368 Doan Hall, Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH 43210
The United States of America
Background: Delirium occurs frequently in intensive care unit (ICU) patients; however, there are limited data evaluating its impact on critically ill hematology-oncology patients. We aimed to determine the incidence and risk factors for early-onset delirium development in hematology-oncology patients admitted to the ICU.
Methods: This single-center, retrospective cohort study evaluated the primary outcome of incident delirium within 7 days of ICU admission in adults admitted to the hematology-oncology medical or surgical ICU. Patients with delirium (DEL) were compared to those without (No-DEL) for evaluation of secondary endpoints including hospital mortality, ICU, and hospital length of stay (LOS). Multivariable logistic regression modeling was performed to identify independent risk factors for delirium.
Results: Delirium occurred in 125 (51.2%) of 244 patients. Inhospital mortality was significantly higher in the DEL vs. No-DEL group (32.8% vs. 15.1%, P = 0.002). Median (1st and 3rd quartiles) ICU and hospital LOS were significantly longer in the delirium group, respectively (6 [4–10] days vs. 3 [2–5] days, P < 0.001, and 21 [14–36] days vs. 12 [8–22] days, P < 0.001). Higher Sequential Organ Failure Assessment score, high-dose corticosteroids, mechanical ventilation (MV), and brain metastases were each independently, associated with an increased delirium risk.
Conclusion: Hematology-oncology patients admitted to the ICU frequently develop delirium. Consistent with literature in nonhematology-oncology critically ill patients, identified independent risk factors for delirium were MV and organ dysfunction. Risk factors unique to the critically ill hematology-oncology patient population include high-dose corticosteroids and brain metastases. Further research is needed to evaluate strategies to mitigate delirium development in this population based on risk assessment.
How to cite this article:
Klosko RC, Arnold JR, Murphy CV, Brimmer J, Hagy N, Exline MC, McLaughlin E, Elefritz JL. Early onset delirium incidence and risk factors in hematology oncology patients admitted to the intensive care unit: A retrospective cohort study.Int J Crit Illn Inj Sci 2022;12:190-196
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How to cite this URL:
Klosko RC, Arnold JR, Murphy CV, Brimmer J, Hagy N, Exline MC, McLaughlin E, Elefritz JL. Early onset delirium incidence and risk factors in hematology oncology patients admitted to the intensive care unit: A retrospective cohort study. Int J Crit Illn Inj Sci [serial online] 2022 [cited 2023 Mar 23 ];12:190-196
Available from: https://www.ijciis.org/article.asp?issn=2229-5151;year=2022;volume=12;issue=4;spage=190;epage=196;aulast=Klosko;type=0 |
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