Evidence map›Paper›PMID 34855749›Full record

Observational studyPloS one2021

ICU delirium burden predicts functional neurologic outcomes.

Luis Paixao, Haoqi Sun, Jacob Hogan, Katie Hartnack, Mike Westmeijer, Anudeepthi Neelagiri, David W Zhou, Lauren M McClain, Eyal Y Kimchi, Patrick L Purdon and 2 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.6field-weighted citation impact, top 17% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Exercise therapy for the treatment of delirium in the intensive care unit.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Review
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

12 authors at 3 institutions in 1 country.

Luis PaixaoDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.
Haoqi SunDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.ORCID 0000-0002-5041-8312
Jacob HoganDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.ORCID 0000-0001-5235-671X
Katie HartnackAntioch University New England, Keene, NH, United States of America.
Mike WestmeijerDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.ORCID 0000-0002-2896-9994
Anudeepthi NeelagiriDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.
David W ZhouHarvard Medical School, Boston, MA, United States of America.ORCID 0000-0002-9635-0472
Lauren M McClainDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.
Eyal Y KimchiDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.ORCID 0000-0003-4327-1102
Patrick L PurdonHarvard Medical School, Boston, MA, United States of America.
Oluwaseun AkejuHarvard Medical School, Boston, MA, United States of America.
M Brandon WestoverDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United States of America.
Harvard University · USMassachusetts General Hospital · USAntioch University New England · US

Funding

Integrative Motor Activity Biomarker for the Risk of Alzheimer's RiskRF1AG064312 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI HU, KUN · 2019 to 2019
$3.6M
Multimodal Network Connectivity Architecture (MOCA) of the Brain and its Role in the Recovery of Consciousness in Comatose Cardiac Arrest PatientsR01NS102574 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GREER, DAVID MATTHEW, WU, ONA · 2018 to 2022
$3.4M
Investigation of Sleep in the Intensive Care Unit (ICU-SLEEP)R01NS102190 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$3.2M
Big Data and Deep Learning for the Interictal-Ictal-Injury ContiuumR01NS107291 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$2.8M
Quantitative Monitoring and Control of Sedation and Pain in the ICU EnvironmentK23NS090900 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2014 to 2018
$988k
Determining optimal parameters for dynamic cholinergic modulation of associative learningK08MH116135 · NIMH · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI KIMCHI, EYAL YAACOV · 2018 to 2021
$783k
NIA NIH HHS RF1 AG064312NIMH NIH HHS K08 MH116135NINDS NIH HHS K23 NS090900NINDS NIH HHS R01 NS102190NINDS NIH HHS R01 NS102574NINDS NIH HHS R01 NS107291
6 · The paper itself

Abstract

backgroundWe investigated the effect of delirium burden in mechanically ventilated patients, beginning in the ICU and continuing throughout hospitalization, on functional neurologic outcomes up to 2.5 years following critical illness.

methodsProspective cohort study of enrolling 178 consecutive mechanically ventilated adult medical and surgical ICU patients between October 2013 and May 2016. Altogether, patients were assessed daily for delirium 2941days using the Confusion Assessment Method for the ICU (CAM-ICU). Hospitalization delirium burden (DB) was quantified as number of hospital days with delirium divided by total days at risk. Survival status up to 2.5 years and neurologic outcomes using the Glasgow Outcome Scale were recorded at discharge 3, 6, and 12 months post-discharge.

resultsOf 178 patients, 19 (10.7%) were excluded from outcome analyses due to persistent coma. Among the remaining 159, 123 (77.4%) experienced delirium. DB was independently associated with >4-fold increased mortality at 2.5 years following ICU admission (adjusted hazard ratio [aHR], 4.77; 95% CI, 2.10-10.83; P < .001), and worse neurologic outcome at discharge (adjusted odds ratio [aOR], 0.02; 0.01-0.09; P < .001), 3 (aOR, 0.11; 0.04-0.31; P < .001), 6 (aOR, 0.10; 0.04-0.29; P < .001), and 12 months (aOR, 0.19; 0.07-0.52; P = .001). DB in the ICU alone was not associated with mortality (HR, 1.79; 0.93-3.44; P = .082) and predicted neurologic outcome less strongly than entire hospital stay DB. Similarly, the number of delirium days in the ICU and for whole hospitalization were not associated with mortality (HR, 1.00; 0.93-1.08; P = .917 and HR, 0.98; 0.94-1.03, P = .535) nor with neurological outcomes, except for the association between ICU delirium days and neurological outcome at discharge (OR, 0.90; 0.81-0.99, P = .038).

conclusionsDelirium burden throughout hospitalization independently predicts long term neurologic outcomes and death up to 2.5 years after critical illness, and is more predictive than delirium burden in the ICU alone and number of delirium days.

Indexed as

Intensive Care UnitsAgedAnalgesicsComaCritical IllnessDeliriumFemaleFollow-Up StudiesHumansHypnotics and SedativesLength of StayMaleMiddle AgedNervous System DiseasesPrevalenceProspective StudiesAnalgesicsHypnotics and Sedatives

Identifiers

PMID34855749
PMCPMC8638853
OpenAlexW3215825277

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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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.