ArticleClinics and practice2026
Early Risk Stratification of Delirium in Intermediate Care Units and Its Impact on 30-Day Mortality: A Decision-Tree Analysis.
Article in Clinics and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDelirium is an under-recognized complication in hospitalized acute care patients, associated with worse outcomes including increased length of stay, higher ICU admission rates and greater mortality. Although screening tools exist for early diagnosis, the absence of admission-based tools limits early risk stratification and timely prevention strategies.
aimTo identify early risk factors for delirium development in IMCU patients and quantify its prognostic role on 30-day mortality.
methodsIn this prospective single-center study, 651 consecutive IMCU patients without delirium at admission were enrolled. Admission variables were analyzed using multivariable logistic regression and Classification and Regression Tree (CART) analysis to identify clinically relevant risk phenotypes. The association between delirium and 30-day mortality was assessed in adjusted models.
resultsDelirium developed in 18.6% of patients within 96 h. Key independent risk factors included age (OR 1.04), male sex (OR 1.75), alcohol use disorder (OR 3.59), cognitive impairment (OR 3.35), COPD (OR 1.68), NEWS (OR 1.18), and need for NIV (OR 3.83). CART analysis identified NIV as the dominant early discriminator, followed by cognitive vulnerability and acute severity. 30-day mortality was significantly higher in patients with delirium (22.3% vs. 9.8%,
conclusionsAdmission-level clinical variables and exploratory CART analysis identified clinically interpretable delirium risk phenotypes in IMCU patients. Delirium was independently associated with increased 30-day mortality. These findings provide a preliminary framework for future validation studies and development of IMCU-specific risk-stratification approaches.
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