Delirium as a predictor of longer hospital stays in mechanically ventilated patients

Background: Respiratory failure is one condition that needs mechanical ventilation in the intensive care unit (ICU). Patients in the ICU are highly vulnerable to the development of delirium due to various reasons. Delirium is associated with more deaths, longer ICU stay, and higher cost. Objective: This study was carried out to determine the relationship between delirium and length of stay in ICU and hospital among mechanically ventilated ICU patients. Materials and Methods: This was a prospective study, conducted on 105 consecutively admitted medical ICU patients requiring mechanical ventilation during hospitalization from 1 June 2013 to 1 may 2014. We assessed delirium using the Confusion Assessment Method for the ICU and Richmond Agitation–Sedation Scale. Cox proportional hazards regression analysis was used to assess the effects of delirium and to determine the relationship between delirium and its variables. Results: Of 105 patients, 48 (45%) patients experienced delirium. Patients who experienced delirium were older in age (mean±SD: 54±16 versus 47±15 years) compared to their counterparts who did not experience delirium. They had a 39% greater risk of remaining in the ICU on any given day even after adjusting for age, gender, race, Charlson comorbidity score, APACHE II score, and coma (HR: 1.12; 95% CI: 0.83–1.52, p = 0.06). Similarly, patients who experienced delirium had a 45% greater risk of remaining in the hospital after adjusting for the same covariates (HR: 1.9; 95% CI 1.3–2.9; p < 0.01). Conclusion: In this study, delirium occurred in nearly half of the mechanically ventilated ICU patients. Even after adjustment for relevant covariates, delirium patients had longer ICU and hospital stay. So delirium is found to be a predictor of longer hospital stays in mechanically ventilated patients.