This project seeks to describe the incidence of delirium in the Intensive Care Unit (ICU) and to identify risk and preventive factors associated with development of delirium. Especially, the investigators want to investigate if an imitated natural light/dark cycle influences frequency of delirium.
A common problem for patients in the ICU is episodes of delirium. Recent trials have described incidences ranging from 60-87% of patients in a number of different countries. Delirium is a condition with fluctuating conscience, disorganized thinking and disturbance of the sleep/wake cycle. Many patients with delirium experience hallucinations and agitation which can be very unpleasant for both patients and their families. Some risk factors for the development of delirium well known, e.g. dementia, hypertension, illness severity (SAPS II score), delirium on the previous day, mechanical ventilation, emergency surgery and metabolic acidosis. The effect of sedative drug administration is not clear, as studies has been inconclusive. Even though studies regarding the impact of sleep deprivation on development of delirium have been inconclusive, there is no doubt that delirious patients have a disturbed sleep-wake cycle, sleep architecture and circadian rhythm. At the intensive care unit at the Department of Anesthesiology at Køge Hospital, three out of nine rooms have a simulated circadian light installed. The idea is that this light rhythm may help to keep a natural circadian rhythm, minimizing the risk of delirium. With this descriptive and retrospective cohort study, the investigators therefore want to describe the incidence and possible risk- and preventive factors of delirium for the participants (ICU patients at Køge Hospital), and with a special focus on the possible effect of imitated circadian light..
Study Type
OBSERVATIONAL
Enrollment
183
Køge Sygehus
Køge, Denmark
Delirium at any time point
Incidence of patients with delirium during ICU-stay defined as at least one positive Confusion Assessment Method for the ICU (CAM-ICU) score or CAM-ICU negative delirium treated with anti-psychotics.
Time frame: Throughout study period, up to 6 months
Days with delirium
Days with positive CAM-ICU or CAM-ICU negative delirium treated with anti-psychotics in relation to length of stay (LOS)
Time frame: Throughout study period, up to 6 months
Circadian light exposure
Difference in incidences of delirium between patients admitted to rooms with circadian rhythm lighting and standard rooms
Time frame: Throughout study period, up to 6 months
Delirium in patients treated with hypnotics
Difference in incidence of delirium in patients treated with hypnotics before admission to hospital (ATC N05C) compared to those who are not
Time frame: Throughout study period, up to 6 months
Delirium in patients treated with steroids
Differences in incidences of delirium in patients that are treated with systemic steroids vs. no treatment
Time frame: Throughout study period, up to 6 months
Mortality
Mortality within ICU stay
Time frame: Throughout study period, up to 6 months
Demographic differences
Incidence of delirium associated to demographic variables (age, gender)
Time frame: Throughout study period, up to 6 months
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Delirium and Simplified Acute Physiology Score (SAPS)
Incidence of delirium associated to Simplified Acute Physiology Score (SAPS) II
Time frame: Throughout study period, up to 6 months
Delirium related to number of ventilator days
Incidence of delirium associated to number of ventilator days
Time frame: Throughout study period, up to 6 months
Delirium related to sedation
Incidence of delirium associated to sedation infusion
Time frame: Throughout study period, up to 6 months
Delirium related to admission type
Incidence of delirium associated to admission type (medical/elective surgical/acute surgical)
Time frame: Throughout study period, up to 6 months
Distribution of types of delirium
Incidence and distribution of delirium subtypes (hypoactive/hyperactive/mixed)
Time frame: Throughout study period, up to 6 months