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).
研究概览
地位
条件
详细说明
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.
研究类型
注册 (实际的)
联系人和位置
学习地点
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Cambridgeshire
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Cambridge、Cambridgeshire、英国、CB23 5EF
- Papworth Hospital NHS Foundation Trust
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Adult patients treated within study time frame on Intensive Care Units across Norfolk, Suffolk, and Cambridgshire, UK
Exclusion Criteria:
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学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
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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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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Delirium prevalence
大体时间: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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Proportion of patient-days with delirium
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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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合作者和调查者
调查人员
- 首席研究员:Alain Vuylsteke, MD、Papworth Hospital NHS Foundation Trust
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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