Frequency And Factors Leading To Intensive Care Unit (ICU) Induced Delirium In Patients Admitted At A Tertiary Care Hospital, Karachi

Objective: To determine the frequency and associated factors leading towards delirium in patients admitted in surgical intensive care (SICU) of tertiary care setting in Karachi  Methods: A cross-sectional study was conducted in patients more than 18 years of age, admitted in a tertiary hospital, Karachi and SICU stay greater than 36 hours. Patients admitted with coma, neurological illness, and profound sedation were excluded from the study. Consecutive, non-probability enrollment was done. Riker Sedation-Agitation Scale (SAS) was used to evaluate sedation; patients with SAS score 4, or more were assessed for delirium using Intensive Care Delirium Screening Checklist (ICDSC). Data was analyzed using SPSS version 26.The independent associations of risk factors were found using binary logistic regression. Results: A total of 135 patients were recruited. The average patient age was 44.16 ±15.84 years. Delirium (Intensive Care Delirium Screening Checklist score (ICDSC 4) was observed in 35 patients (25.9%). On multivariable regression analysis, significant predictors of delirium included older age, longer hospital and ICU stay, chronic obstructive pulmonary disease (COPD), pain score >4 ,hypernatremia, exposure to midazolam and propofol.   Conclusion: The study findings suggest that one out of every four surgical ICU patients was found to have delirium, numerous associated factors for delirium have been identified by logistic regression including old age, sedation, pain, and prolonged ICU stay. Identification of modifiable risk factors for delirium in the intensive care unit may help improve the management of critically ill patients.