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Risk factors of delirium in ICU and cluster intervention and prevention measures
Chen Guoqing, Xu Juan, Song Xiuyin, Zhao Caihong, Guo Yanping
Published 2021-08-08
Cite as Int J Nurs, 2021, 40(15): 2716-2719. DOI: 10.3760/cma.j.cn221370-20200329-00774
Abstract
ObjectiveTo study the delirium risk factors of intensive care unit(ICU)and to explore the clustering intervention prevention measures for clustering.
MethodsA total of 288 critically ill patients admitted to the ICU of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from December 2016 to December 2018 were selected as the study subjects.According to whether delirium occurred during ICU observation, the patients were divided into delirium group and non-delirium group, with 112 cases and 176 cases, respectively.The medical records such as age, gender, and disease type were collected.The independent risk factors of ICU delirium were investigated by univariate analysis and Logistic regression analysis between groups, and cluster intervention and prevention measures were developed based on this.
ResultsDelirium occured in 112 of 288 ICU patients, and the incidence of delirium was 38.89%.There were significant differences in age, mechanical ventilation, benzodiazepine use history, disease type, hypoxemia, acute physiology and chronic health score(APACHE-Ⅱ)scores between the delirium group and non-delirium group(P<0.05). There was no significant difference in gender, combined diabetes mellitus, combined hypertension and smoking history between the two groups(P>0.05). Hypoxemia(OR=2.076), mechanical ventilation(OR=2.863), history of use of benzodiazepines(OR=2.987), major surgery(OR=3.321) and severe trauma(OR=3.091)were independent risk factors for ICU delirium.
ConclusionsThe incidence of ICU delirium is high, which is affected by multiple factors such as severe trauma, mechanical ventilation, benzodiazepines, hypoxemia, etc.Therefore, appropriate cluster intervention and prevention measures can be developed based on the above evidence-based basis.
Key words:
ICU; Delirium; Clustering intervention
Contributor Information
Chen Guoqing
Tongji Medical College of Huazhong University of Science and Technology School of Medicine and Health Management, Wuhan 434000, China
Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 434000, China
Xu Juan
Tongji Medical College of Huazhong University of Science and Technology School of Medicine and Health Management, Wuhan 434000, China
Song Xiuyin
Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 434000, China
Zhao Caihong
Scientific Research Office, People's Hospital of Wuhan University, 434000, China
Guo Yanping
Houbo School of Nursing, Xinjiang Medical University, Karamay 834000, China
类药使用史、疾病类型、低氧血症、急性生理与慢性健康评分系统(APACHE)Ⅱ评分比较差异有统计学意义(P<0.05)，两组性别、合并糖尿病、合并高血压、吸烟史比较差异无统计学意义(P>0.05);低氧血症(OR＝2.076)、机械通气(OR＝2.863)、苯二氮
类药使用史(OR＝2.987)、大型手术(OR＝3.321)、严重创伤(OR＝3.091)是ICU谵妄的独立危险因素。
类药物、低氧血症等多种因素的影响，可根据上述循证基础制定相应的集束化干预预防措施。
