INCIDENCE, RISK FACTORS AND IMPACT ON OUTCOME IN OBSERVATIONAL STUDY OF DELIRIUM IN CARDIAC ICU.
Authors: Ainchwar Rohan , Dhanraj Ramteke Harshawardhan , Sheikh Saniya 
Published: October 2021

Introduction: Many Patients admitted to Cardiac ICU (CICU) are easily prone to Delirium, that can lead to potentially severe consequences like
Cognitive Impairment and increased risks of mortality. Delirium depends on the duration of hospital stay and discharge, contrary mainly affected to
the patients on mechanical ventilation, which becomes the potential reason for longer duration. Studies suggest, Delirium is a widely discussed
topic, when comes to the management of the patient in Cardiac ICU. During the Rounds, it is mandatory to focus on the diagnosis of delirium and
must be validated using Confusion Assessment Method (CAM). These methods not only prevent the risk of the delirium and also enhances the use
of the other preventive measures like the basis of the treatment, environmental factors, quiet time, sleep promotion, family support, communication
with the patient, pain and dyspnea. When conrmed with delirium, pharmacological prophylaxis must be used as soon as possible. Most often,
communication between Doctor, Nurse and Patient drives the most of the depression and acute delirium, but when delirium becomes critical with
severe agitation or weaning from invasive mechanical ventilation. Thus, it is very important to identify the risk, complexity of the patients and
clinical case scenarios of delirium in Cardiac ICU. Strategic Efforts were done to improve the identication of the patient at risk during admission,
during stay at Cardiac ICU and during discharge and orders to improve the mental state of delirium patient. In this article, we provide a panorama of
the incidence, risk factors, and impact on outcome of delirium in a Cardiac Intensive Care Unit (CICU).
Methods: In this case study, total of 211 patients were observed for sign and symptoms in Cardiac ICU for Delirium. We aimed to determine the
incidence, risk factors, and impact on outcome of delirium in a Cardiac Intensive Care Unit (CICU) in CHLMultispeciality Hospital and Research
Center, Chandrapur using a prospective observational study.
Patients:All consecutive patients admitted to the CICU between April 2021 and June 2021 were included if they were aged more than 18 years, had
an CICU stay of more than 24 h and no psychiatric history. Patients eligible for the study were evaluated by the medical staff to detect delirium using
the CAM.
Results: In a 3-month period, 211 Patients were admitted in Cardiac ICU of CHLMultispeciality Hospital and Research Center. Out of which 198
were included in our observational study. The incidence of delirium at the end of the study was 21%. The number of delirious patients were 43 and
non-delirious were 155. Age played an Important factor where 86% of Delirious patients were old aged. The LOS (Length of Stay) for Delirious
and non-delirious patients were 6±1 vs 5±1 respectively. The SAS (Riker Agitation Scale) has the value of 4±1 vs 3±0.5, CAM (Confusion
Assessment Method) has the value of 6±1 vs 3±1 and DDS (Delirium Detection Score) was 5±1 vs 3±1 for delirious vs non-delirious patients. The
SAPS II (Simplied Acute Physiology Score II) Score for delirious patients was 23±1 and 20±2. The Incidences like Removal of Catheters were
more frequent in this study with 20% in delirious patients and <1% Incidence in non-delirious patients. Removal of ET Tube had the Incidence of
5% vs <1%, Removal of Urinary Catheter 7% vs <1%, Removal of Ryle's Tube 7% vs <1%, respectively for delirious vs non-delirious patients.