Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study

Background Delirium remains understudied after traumatic brain injury (TBI). We sought to identify independent predictors of delirium among intensive care unit (ICU) patients with TBI. Methods This single-center retrospective cohort study evaluated adult patients with TBI requiring ICU admission. Ou...

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Bibliographic Details
Published in:Neurocritical care 2023-06, Vol.38 (3), p.752-760
Main Authors: Wilson, Laura D., Maiga, Amelia W., Lombardo, Sarah, Nordness, Mina F., Haddad, Diane N., Rakhit, Shayan, Smith, Laney F., Rivera, Erika L., Cook, Madison R., Thompson, Jennifer L., Raman, Rameela, Patel, Mayur B.
Format: Article
Language:English
Subjects:
Adult
Benzodiazepines
Brain Injuries, Traumatic - complications
Brain Injuries, Traumatic - epidemiology
Cardiopulmonary resuscitation
Classification
Cohort analysis
Coma
Concussion
Consciousness
CPR
Critical Care Medicine
Delirium
Delirium - epidemiology
Delirium - etiology
Epidural
Glasgow Coma Scale
Hemoglobin
Hemorrhage
Hospitals
Humans
Intensive
Intensive care
Intensive Care Units
Internal Medicine
Length of stay
Medical records
Medicine
Medicine & Public Health
Mortality
Narcotics
Neurology
Neurosurgery
Original Work
Patients
Population
Prevalence
Retrospective Studies
Risk Factors
Subarachnoid Hemorrhage - complications
Trauma
Traumatic brain injury
Variables
Ventilators
Workers compensation
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Description
Summary:Background Delirium remains understudied after traumatic brain injury (TBI). We sought to identify independent predictors of delirium among intensive care unit (ICU) patients with TBI. Methods This single-center retrospective cohort study evaluated adult patients with TBI requiring ICU admission. Outcomes included delirium days within the first 14 days, as assessed by the Confusion Assessment Method-ICU (CAM-ICU). Models were adjusted for age, sex, insurance, Marshall head computed tomography classification, presence of subarachnoid hemorrhage (SAH), Injury Severity Score (ISS), need for cardiopulmonary resuscitation, maximum admission Glasgow Coma motor score, glucose level, hemoglobin level, and pupil reactivity. Results Delirium prevalence was 60%, with a median duration of 4 days (interquartile range: 2–8) among ICU patients with TBI ( n  = 2,664). Older age, higher ISS, maximum motor score 
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-022-01666-1