The attributable mortality of delirium in critically ill patients: prospective cohort study

Abstract

Objective To determine the attributable mortality caused by delirium in critically ill patients. Design Prospective cohort study. Setting 32 mixed bed intensive care unit in the Netherlands, January 2011 to July 2013. Participants 1112 consecutive adults admitted to an intensive care unit for a minimum of 24 hours. Exposures Trained observers evaluated delirium daily using a validated protocol. Logistic regression and competing risks survival analyses were used to adjust for baseline variables and a marginal structural model analysis to adjust for confounding by evolution of disease severity before the onset of delirium. Main outcome measure Mortality during admission to an intensive care unit. Results Among 1112 evaluated patients, 558 (50.2%) developed at least one episode of delirium, with a median duration of 3 days (interquartile range 2-7 days). Crude mortality was 94/558 (17%) in patients with delirium compared with 40/554 (7%) in patients without delirium (PConclusions Overall, delirium prolongs admission in the intensive care unit but does not cause death in critically ill patients. Future studies should focus on episodes of persistent delirium and its long term sequelae rather than on acute mortality. Trial registration Clinicaltrials.gov NCT01905033.