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Neurocritical Care
Published in: Neurocritical Care 3/2023

31-01-2023 | Central Nervous System Trauma | Original Work

Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study

Authors: Laura D. Wilson, Amelia W. Maiga, Sarah Lombardo, Mina F. Nordness, Diane N. Haddad, Shayan Rakhit, Laney F. Smith, Erika L. Rivera, Madison R. Cook, Jennifer L. Thompson, Rameela Raman, Mayur B. Patel

Published in: Neurocritical Care | Issue 3/2023

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Abstract

Background

Delirium remains understudied after traumatic brain injury (TBI). We sought to identify independent predictors of delirium among intensive care unit (ICU) patients with TBI.

Methods

This single-center retrospective cohort study evaluated adult patients with TBI requiring ICU admission. Outcomes included delirium days within the first 14 days, as assessed by the Confusion Assessment Method-ICU (CAM-ICU). Models were adjusted for age, sex, insurance, Marshall head computed tomography classification, presence of subarachnoid hemorrhage (SAH), Injury Severity Score (ISS), need for cardiopulmonary resuscitation, maximum admission Glasgow Coma motor score, glucose level, hemoglobin level, and pupil reactivity.

Results

Delirium prevalence was 60%, with a median duration of 4 days (interquartile range: 2–8) among ICU patients with TBI (n = 2,664). Older age, higher ISS, maximum motor score < 6, Marshall class II–IV, and SAH were associated with risk of increased delirium duration (all p < 0.001).

Conclusions

In this large cohort, ICU delirium after TBI affected three of five patients for a median duration of 4 days. Age, general injury severity, motor score, and features of intracranial hemorrhage were predictive of more TBI-associated delirium days. Given the high prevalence of ICU delirium after TBI and its impact on hospitalization, further work is needed to understand the impact of delirium and TBI on outcomes and to determine whether delirium risk can be minimized.
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Metadata
Title
Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study
Authors
Laura D. Wilson
Amelia W. Maiga
Sarah Lombardo
Mina F. Nordness
Diane N. Haddad
Shayan Rakhit
Laney F. Smith
Erika L. Rivera
Madison R. Cook
Jennifer L. Thompson
Rameela Raman
Mayur B. Patel
Publication date
31-01-2023
Publisher
Springer US
Published in
Neurocritical Care / Issue 3/2023
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-022-01666-1

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