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Learning Objective 1: The learner will be able to understand the high incidence rate of the elderly patients at ICU.
Learning Objective 2: The learner will be able to realize the role of clinical health professional regarding identifying risk factors of delirium.
Methods: A cross-sectional observational design was used in the study. The subjects aged over 65 and admitted within 24 hours were included. Those re-admitted and RASS scores lower than -3 were excluded. Each subject was recorded his/her demographic data, and assessed twice a day with CAM-ICU and RASS.
Results: The study was conducted at a medical ICU of a medical center in Taiwan. Totally 90 patients included in this study. The incidence rate of delirium was established at 75.6% (n=68). The average age of the subjects was 78.28±7.6. APACH II scores ranged 7 to 35(mean= 22.72±5.46). Respiratory failure (n=66, 73.3%) was the primary diagnosis. Most patients developed delirium within 24 hours after admission (n=68,86.76%.). The average day of having delirium was 3.62±2.98. The mixed subtype of delirium was the most(N=68,47.05%),and hypoactive subtype, next.(N=68,38.24%). Using the logistic regression, number of medication use, number of analgesic use, days of dehydration, shock and history of using steroid statistically stood out as the risk factors of delirium, which explained 31.3 of variance. The length of day of delirium was related to old age, number of use of Catheter, days of dehydration, and use of ventilator.
Conclusions: The incidence of delirium among elderly patients at ICU is very high. Clinical health professionals should pay more attention on the elderly patients at ICU, especially, as those are at old age, nurses should evaluate essential use of medication, prevent the event of dehydration, and eliminate the use of catheter.