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Investigators are seeking to determine the impact of recent alcohol, smoking or psychotropic drug use prior to intensive care unit (ICU) admission on incidence of delirium and sedation requirements.
Study design: A prospective observational study, in a medical ICU of a tertiary university hospital.
Methods: For all new ICU admissions, a 1-page questionnaire including Alcohol Use Disorders Identification Test (AUDIT-C), smoking history and prior medication use was given to the patient or closest family members.
Delirium was assessed by trained ICU nurses using Intensive Care Delirium Screening Checklist and Richmond Agitation-Sedation Scale.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AUDIT-C > 4 | Significant alcohol use within 1 year prior to ICU admission (AUDIT-C>4) |
| |
| AUDIT-C <=4 | No significant alcohol use within 1 year prior to ICU admission (AUDIT-C: equal or less than 4) |
| |
| Smoking history positive last year | Who smoke cigarette within 1-year prior to ICU admission |
| |
| Smoking history negative last year | Who did not smoke cigarette within 1-year prior to ICU admission |
| |
| Prior psychotropic medication use - yes | Who used psychotropic medication within 1-year prior to ICU admission |
| |
| Prior psychotropic medication use - no | Who did not use psychotropic medication within 1-year prior to ICU admission |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AUDIT-C | Other | Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including AUDIT-C about his/her alcohol behavior during last year and will be categorized into two groups: Those with AUDIT-C>4 versus AUDIT-C of 4 or below. |
| Measure | Description | Time Frame |
|---|---|---|
| Delirium during ICU stay | From date of ICU admission until the date of ICU discharge, whichever came first, assessed up to 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| ICU length of stay | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months | |
| Mortality | Death in MICU | From date of ICU admission until the date of death, assessed up to 3 months |
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Inclusion Criteria:
Exclusion Criteria:
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For all new ICU admissions above age of 18 years, except for those who fulfill exclusion criteria
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| Name | Affiliation | Role |
|---|---|---|
| Jinwoo Lee, Professor | Seoul National University Hospital | Study Chair |
| Jungsil Lee, M.D. | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 110744 | South Korea |
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| ID | Term |
|---|---|
| D013375 | Substance Withdrawal Syndrome |
| D003693 | Delirium |
| ID | Term |
|---|---|
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
| D003221 | Confusion |
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| ID | Term |
|---|---|
| D000431 | Ethanol |
| ID | Term |
|---|---|
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
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|
| Smoking history | Other | Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including smoking history during last year and will be categorized into two groups: Current smoker versus ex- or never smoker (we also recorded smoking pack-years to distinguish heavy smokers) |
|
| Prior psychotropic medication use | Other | Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including psychotropic medication use prior admission to ICU and will be categorized into two groups: Those who use psychotropic medication versus those who do not use psychotropic medication. |
|
| Maximal doses of dexmedetomidine | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months |
| Cumulative dose of dexmedetomidine | Cumulative dose of dexmedetomidine during the patient's MICU stay | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months |
| Cumulative dose of midazolam | Cumulative dose of midazolam during the patient's MICU stay | From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months |
| D019954 |
| Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019965 | Neurocognitive Disorders |