Petras Navickas1, Pranas Šerpytis2,3,4, Alvydas Navickas5, Karolis Šerpytis6, Rokas Šerpytis1,2
1Vilnius University Medical Faculty, Vilnius, Lithuania
2Vilnius University Hospital Santariškių Klinikos, Centre of Cardiology and Angiology, Vilnius, Lithuania
3Vilnius University Hospital Santariškių Klinikos, Centre of Emergency Medicine, Vilnius, Lithuania
4Vilnius University Medical Faculty Clinic of Cardiac and Vascular Diseases, Vilnius, Lithuania
5Vilnius University Medical Faculty Psychiatric Clinic, Vilnius, Lithuania
6Vilnius University Econonomics Faculty, Vilnius, Lithuania
Background and objective: Over the past two decades, delirium has become a widely investigated subject and recent studies that investigate delirium explicitly in the cardiovascular intensive care unit (ICCU) have filled a number of gaps in the questions concerning this complication. Nonetheless, due to limitations with existing studies, there are still a few obscurities yet to be interpreted. We therefore aimed to determine the approximate impact of delirium in a ICCU setting over a five-year period.
Methods: An observational study was carried out to investigate all patients who were admitted to the ICCU of Vilnius University Hospital Santariškių Clinics, Lithuania from 1 January 2011 to 31 December 2015. The retrospective analysis encompassed 19,007 ICCU admissions.
Results: Of the 19,007 admissions, 337 were diagnosed with delirium, while 18,670 patients were not diagnosed with the condition. Analysis of the time of onset of delirium showed that delirium developed on average after 4 days of hospitalization and did not statistically significantly differ between genders. The length of stay (LOS) in the ICCU was nearly threefold longer in patients with delirium (6.2 ± 0.341 days, 95% confidence interval [CI] 5.53 – 6.87) than those without delirium (2.2 ± 0.021 days, 95% CI 2.15 – 2.23, p < 0.001). The overall LOS in the hospital was also significantly more prolonged in patients with delirium than in the non-delirium group (14.8 ± 1.441, 95% CI 12.01 – 17.68 vs. 7.5 ± 0.106, 95% CI 7.33 – 7.75, p < 0.001).
Conclusions: Our analysis demonstrated that delirium has an immense impact on patients in the ICCU and also that the resources needed to manage this complication are high. Delirium was associated with worse outcomes and prolonged overall lengths of stay in both the ICCU and hospital overall. These findings were distinctly more marked in men than women.