Evidence map›Paper›PMID 22903241›Full record

ArticleIntensive care medicine2012

Associations of markers of inflammation and coagulation with delirium during critical illness.

Timothy D Girard, Lorraine B Ware, Gordon R Bernard, Pratik P Pandharipande, Jennifer L Thompson, Ayumi K Shintani, James C Jackson, Robert S Dittus, E Wesley Ely

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04081090 (Structured Cognitive Therapy to Improve Neurocognitive Dysfunction in Older Intensive Care Unit Sepsis Survivors), which is not on this map. Cited by 69 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 9 pooled it
5.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04081090 naterminatednot on this mapstarted 2019, after this paper: background citation

Structured Cognitive Therapy to Improve Neurocognitive Dysfunction in Older Intensive Care Unit Sepsis Survivors

TypeinterventionalSponsorMedical College of WisconsinRan2019 to 2020Enrolled1ConditionsNeurocognitive DisordersArmsBrain HQ Cognitive Modules
3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 9 syntheses or guidelines pooled it, 132 citations in OpenAlex.

  1. Pooled it
  2. Five-decade prevalence of delirium in pneumonia, risk factors and associated mortality: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025
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  19. Inflammatory Indices and Their Associations With Postoperative Delirium.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024
    Article
  20. Article

9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Timothy D GirardVanderbilt University School of Medicine, Nashville, TN 37232-8300, USA. timothy.girard@vanderbilt.edu
Lorraine B Ware
Gordon R Bernard
Pratik P Pandharipande
Jennifer L Thompson
Ayumi K Shintani
James C Jackson
Robert S Dittus
E Wesley Ely
Vanderbilt University · USGeriatric Research Education and Clinical Center · USVA Tennessee Valley Healthcare System · US

Funding

VANDERBILT UNIVERSITY CTSA FOR PEDIATRIC RESEARCHUL1RR024975 · NCRR · VANDERBILT UNIVERSITY · PI BERNARD, GORDON RAPHAEL · 2007 to 2011
$45.7M
The MIND USA StudyR01AG035117 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ELY, E WESLEY · 2011 to 2016
$7.3M
The MIND ICU StudyR01AG027472 · NIA · VANDERBILT UNIVERSITY · PI ELY, E WESLEY · 2006 to 2010
$3.0M
The Vanderbilt Institute for Clinical and Translational Research (VICTR) KL2KL2RR024977 · NCRR · VANDERBILT UNIVERSITY · PI BERNARD, GORDON RAPHAEL · 2007 to 2011
$3.0M
PATHOPHYSIOLOGY OF THE PULMONARY MICROCIRCULATION:T32HL007123 · NHLBI · VANDERBILT UNIVERSITY · PI BERNARD, GORDON R. · 1985 to 2004
$2.7M
Midcareer Investigator Award in Patient-Oriented Research in Acute Lung InjuryK24HL103836 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WARE, LORRAINE B · 2010 to 2020
$1.6M
The Vanderbilt Institute for Clinical and Translational Research (VICTR) TL1TL1RR024978 · NCRR · VANDERBILT UNIVERSITY · PI BERNARD, GORDON RAPHAEL · 2007 to 2011
$1.3M
Predictors of Cognitive Impairment in Survivors of Critical IllnessK23AG034257 · NIA · VANDERBILT UNIVERSITY · PI GIRARD, TIMOTHY D · 2009 to 2013
$684k
Cognitive Impairment in the ICU: Evaluation and OutcomesK23AG001023 · NIA · VANDERBILT UNIVERSITY · PI ELY, E WESLEY · 2001 to 2005
$621k
Executive Dysfunction and Functional Impairment in Elderly ICU SurvivorsK23AG031322 · NIA · VANDERBILT UNIVERSITY · PI JACKSON, JAMES C. · 2008 to 2012
$556k
NCRR NIH HHS KL2 RR024977NCRR NIH HHS TL1 RR024978NCRR NIH HHS UL1 RR024975NHLBI NIH HHS HL007123NHLBI NIH HHS HL103836NHLBI NIH HHS K24 HL103836NHLBI NIH HHS T32 HL007123NIA NIH HHS AG001023NIA NIH HHS AG027472NIA NIH HHS AG031322NIA NIH HHS AG034257NIA NIH HHS AG035117NIA NIH HHS K23 AG001023NIA NIH HHS K23 AG031322NIA NIH HHS K23 AG034257NIA NIH HHS R01 AG027472NIA NIH HHS R01 AG035117
6 · The paper itself

Abstract

purposeTo assess the associations between a priori-selected markers of inflammation and coagulation and delirium during critical illness.

methodsIn this prospective cohort study, we collected blood from mechanically ventilated medical intensive care unit (ICU) patients and measured nine plasma markers of inflammation and coagulation. We assessed patients daily for delirium using the Confusion Assessment Method for the ICU and used multivariable regression to analyze the associations between plasma markers and subsequent delirium, after adjusting for age, severity of illness, and sepsis.

resultsAmong the 138 patients studied, with median age of 66 years and median Acute Physiology and Chronic Health Evaluation (APACHE) II of 27, 107 (78 %) were delirious at some point during the study. Two markers of inflammation and one of coagulation were significantly associated with delirium. After adjusting for covariates, lower plasma concentrations of matrix metalloproteinase-9 (MMP-9) and protein C were associated with increased probability of delirium (p = 0.04 and 0.01, respectively), and higher concentrations of soluble tumor necrosis factor receptor-1 (sTNFR1) were associated with increased probability of delirium (p < 0.01). Concentrations of C-reactive protein (p = 0.82), myeloperoxidase (p = 0.11), neutrophil gelatinase-associated lipocalin (p = 0.70), D-dimer (p = 0.83), plasminogen activator inhibitor type 1 (p = 0.98), and Von Willebrand factor antigen (p = 0.65) were not associated with delirium.

conclusionsIn this study, MMP-9, protein C, and sTNFR1 were independently associated with subsequent ICU delirium. These results suggest that specific aspects of inflammation and coagulation may play a role in the evolution of delirium during critical illness and that these markers should be examined in larger studies of ICU patients.

Indexed as

AgedBiomarkersBlood Coagulation DisordersDeliriumFemaleHumansInflammationMaleMiddle AgedMultivariate AnalysisProspective StudiesRespiration, ArtificialRisk FactorsBiomarkers

Identifiers

PMID22903241
PMCPMC3606929
OpenAlexW2072400349

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.