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ICU Delirium: a One-week Snapshot of Burden Across the Eastern UK Region

17 juli 2013 uppdaterad av: Papworth Hospital NHS Foundation Trust

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).

Studieöversikt

Status

Avslutad

Betingelser

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Faktisk)

225

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Storbritannien
    • Cambridgeshire
      • Cambridge, Cambridgeshire, Storbritannien, CB23 5EF
        • Papworth Hospital NHS Foundation Trust

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Sannolikhetsprov

Studera befolkning

Adult critically ill patients across eastern UK region

Beskrivning

Inclusion Criteria:

  • Adult patients treated within study time frame on Intensive Care Units across Norfolk, Suffolk, and Cambridgshire, UK

Exclusion Criteria:

-

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Adult critically ill patients
All adult patients treated within study time frame on Intensive Care Units across Norfolk, Suffolk, and Cambridgshire, UK

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Delirium prevalence
Tidsram: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Proportion of patient-days with delirium
Tidsram: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Number of patient-days with at least one recorded delirium-positive result over total patient-days recorded.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Median delirium duration
Tidsram: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients: median number of days recorded with delirium over study time frame.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Median days to transition to delirium
Tidsram: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients admitted during study time frame: median number of days from ICU admission to first recorded delirium day.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Patient age, by delirium status
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: median age.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Patient gender, by delirium status
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: number of males over total patients in each group.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Admission type, by delirium status
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Admission reason, by delirium status
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Organ support, by delirium status
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Mobilisation therapy, by delirium status
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Median ICU days, by delirium status
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Delirium screening compliance
Tidsram: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
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.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Papworth Hospital NHS Foundation Trust

Samarbetspartners

Norfolk, Suffolk, and Cambridgeshire Critical Care Network (NSC CCN)

Utredare

  • Huvudutredare: Alain Vuylsteke, MD, Papworth Hospital NHS Foundation Trust

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 juni 2012

Primärt slutförande (Faktisk)

1 juli 2012

Avslutad studie (Faktisk)

1 juli 2012

Studieregistreringsdatum

Först inskickad

15 juli 2013

Först inskickad som uppfyllde QC-kriterierna

17 juli 2013

Första postat (Uppskatta)

18 juli 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

18 juli 2013

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

17 juli 2013

Senast verifierad

1 juli 2013

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • P01535

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