ICU Delirium: a One-week Snapshot of Burden Across the Eastern UK Region
ICU delirium negatively impacts on patient outcomes, as well as on resources and clinical workflow of the ICU. Effective healthcare resource planning requires reliable (i.e., multicentre) data that can inform on both of these.
The purpose of this study was to determine the impact of ICU delirium in terms of both patients and beds. The study was carried out prospectively, over a one-week period, at adult ICUs comprising the Norfolk, Suffolk, and Cambridgeshire Critical Care Network (NSC CCN).
調査の概要
状態
条件
詳細な説明
Previous delirium prevalence research has been carried out at single sites and yielded highly variable results (between 3-87%). Reliable multisite data can be obtained cost-effectively using a point-prevalence ("snapshot") approach.
Purpose: to obtain reliable data informing on prevalence of ICU delirium, in terms of both patients and beds, across the eastern UK region.
Design and Setting: this one-week observational prospective cohort study was carried out between June 25, 2012 (start of ICU day shift) to July 01, 2012 (end of night shift). Nine ICUs comprising the Norfolk, Suffolk, and Cambridgeshire Critical Care Network (NSC CCN) took part. Cambridgeshire 2 Research Ethics Committee approved the study (REC reference: 10/H0308/116) and waived the need for informed consent.
Patients and procedure: All adults treated over the study week at participating ICUs were considered eligible for inclusion. Delirium screening was carried out by patients' direct care clinicians using the Confusion Assessment Method for the ICU (CAM-ICU). All sites used this tool as part of their routine clinical practice and had delirium management guidelines in place at the time of the study. Patients who screened positive for delirium were treated according to local hospital practice.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Cambridgeshire
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Cambridge、Cambridgeshire、イギリス、CB23 5EF
- Papworth Hospital NHS Foundation Trust
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Adult patients treated within study time frame on Intensive Care Units across Norfolk, Suffolk, and Cambridgshire, UK
Exclusion Criteria:
-
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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Adult critically ill patients
All adult patients treated within study time frame on Intensive Care Units across Norfolk, Suffolk, and Cambridgshire, UK
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Delirium prevalence
時間枠：June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Number of patients with at least one recorded delirium-positive result, over total number of patients recorded over study time frame.
Delirium screening will be carried out using the CAM-ICU by local direct care clinicians in accordance with region-wide clinical delirium-screening guidelines.
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June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Proportion of patient-days with delirium
時間枠：June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Number of patient-days with at least one recorded delirium-positive result over total patient-days recorded.
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June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Median delirium duration
時間枠：June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients: median number of days recorded with delirium over study time frame.
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June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Median days to transition to delirium
時間枠：June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients admitted during study time frame: median number of days from ICU admission to first recorded delirium day.
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June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Patient age, by delirium status
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients versus patients with no recorded delirium-positive result over study time frame: median age.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Patient gender, by delirium status
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients versus patients with no recorded delirium-positive result over study time frame: number of males over total patients in each group.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Admission type, by delirium status
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients versus patients with no recorded delirium-positive result over study time frame: number of (1) urgent/emergency and (2) elective admissions, over total patients in each group.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Admission reason, by delirium status
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients versus patients with no recorded delirium-positive result over study time frame: number of (1) medical and (2) surgical admissions, over total patients in each group.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Organ support, by delirium status
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients versus patients with no recorded delirium-positive result over study time frame: number receiving advanced and basic respiratory, advanced and basic cardiovascular, and renal support since ICU admission to end of study time frame, over total patients in each group.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Mobilisation therapy, by delirium status
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients versus patients with no recorded delirium-positive result over study time frame: number receiving mobilisation therapy over study time frame, over total patients in each group.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Median ICU days, by delirium status
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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In delirium patients versus patients with no recorded delirium-positive result over study time frame: median number of patient-days in ICU per patient, since admission to end of study time frame.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Delirium screening compliance
時間枠：June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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Number of patient-days CAM-ICU administered (1) once or more and (2) twice or more, over total number of patient-days recorded over study time frame.
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June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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協力者と研究者
捜査官
- 主任研究者：Alain Vuylsteke, MD、Papworth Hospital NHS Foundation Trust
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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