Evidence map›Paper›PMID 36539913›Full record

ArticleJournal of intensive care2022

Prognostic significance of delirium subtypes in critically ill medical and surgical patients: a secondary analysis of a prospective multicenter study.

Lisa Smit, Eveline J A Wiegers, Zoran Trogrlic, Wim J R Rietdijk, Diederik Gommers, Erwin Ista, Mathieu van der Jagt

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

Article in Journal of intensive care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01952899 (Improvement of Care for ICU Patients With Delirium by Early Screening and Treatment), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 19% 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.

NCT01952899 unknown statusnot on this map

Improvement of Care for ICU Patients With Delirium by Early Screening and Treatment

Typeobservational_patient_registrySponsorErasmus Medical CenterRan2012 to 2016Enrolled1,500ConditionsDelirium
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  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

7 authors at 1 institution in 1 country.

Lisa SmitDepartment of Intensive Care Adults, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. l.smit@erasmusmc.nl.ORCID http://orcid.org/0000-0001-5199-930X
Eveline J A WiegersDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Zoran TrogrlicDepartment of Intensive Care Adults, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Wim J R RietdijkDepartment of Hospital Pharmacy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Diederik GommersDepartment of Intensive Care Adults, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Erwin IstaIntensive Care Unit, Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands.
Mathieu van der JagtDepartment of Intensive Care Adults, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Erasmus MC · NL

Funding

ZonMw 171203008
6 · The paper itself

Abstract

backgroundThe prognostic implication of delirium subtypes in critically ill medical and surgical patients is scarcely investigated. The objective was to determine how delirium subtypes are associated with hospital mortality and other clinical outcomes.

methodsWe performed a secondary analysis on data from a prospective multicenter study aimed at implementation of delirium-oriented measures, conducted between 2012 and 2015 in The Netherlands. We included adults (≥ 18 years) admitted to the medical or surgical intensive care unit (ICU). Exclusion criteria were neurological admission diagnosis, persistent coma or ICU readmissions. Delirium was assessed using the Confusion Assessment Method-ICU or Intensive Care Delirium Screening Checklist, and delirium subtypes (hypoactive, hyperactive, or mixed) were classified using the Richmond Agitation-Sedation Scale. The main outcome was hospital mortality. Secondary outcomes were ICU mortality, ICU length of stay, coma, mechanical ventilation, and use of antipsychotics, sedatives, benzodiazepines and opioids.

resultsDelirium occurred in 381 (24.4%) of 1564 patients (52.5% hypoactive, 39.1% mixed, 7.3% hyperactive). After case-mix adjustment, patients with mixed delirium had higher hospital mortality than non-delirious patients (OR 3.09, 95%CI 1.79-5.33, p = 0.001), whereas hypoactive patients did not (OR 1.34, 95%CI 0.71-2.55, p = 0.37). Similar results were found for ICU mortality. Compared to non-delirious patients, both subtypes had longer ICU stay, more coma, increased mechanical ventilation frequency and duration, and received more antipsychotics, sedatives, benzodiazepines and opioids. Except for coma and benzodiazepine use, the most unfavourable outcomes were observed in patients with mixed delirium.

conclusionsPatients with mixed delirium had the most unfavourable outcomes, including higher mortality, compared with no delirium. These differences argue for distinguishing delirium subtypes in clinical practice and future research. Trial registration ClinicalTrials.gov NCT01952899.

Indexed as

Critical careCritical care outcomesDeliriumIntensive care unitMortalitySubtype

Identifiers

PMID36539913
PMCPMC9764534
OpenAlexW4311954897

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.