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Delirium is frequently observed among critically ill patients and is associated with detrimental outcomes. Currently, no evidence-based prevention or treatment exists for delirium, and especially, the inability to identify effective preventive measures of delirium has increased the focus on identifying patients with a high risk of delirium through prediction models. Two prediction models have been developed to estimate the risk of delirium in ICU patients: the prediction model for delirium (PRE-DELIRIC) and the early prediction model for delirium (E-PRE-DELIRIC). These robust and well-calibrated prediction models have the potential of assisting in identifying patients with the highest risk for delirium and thereby to focusing preventive strategies on the most vulnerable group. However further validation is needed in a Danish population.
Adult ICU patients admitted to the participating ICUs in the Region Zealand are included according to eligibility.
Eligible patients will be assessed with E-PREDELIRIC at admission to the ICU and PREDELIRIC 24h after admission to the ICU. Patients will be screened twice daily with CAM-ICU until ICU discharge, death, transferal to non-participating ICU or for a maximum observation period of 14 days.
Central screening via EPIC PDM and registration in central database (REDCap, ZUH) by the principal investigator.
The following are registered: Age, sex, history of cognitive impairment, history of alcohol abuse, admission category, urgent admission, mean arterial blood pressure at the time of ICU admission, use of corticosteroids, respiratory failure, Blood Urea Nitrogen/Carbamide, APACHE-II score, administered morphine does, use of sedatives, metabolic acidosis, coma, presence of infection, delirium status by CAM-ICU, time of ventilation, length of ICU and hospital stay, mortality.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Adult patients admitted to Intensive Care Unit (ICU) | Eligible patients are scored by E-PRE-DELIRIC at admission and PRE-DELIRIC 24 hours after admission. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prediction models | Other | The prediction scores are validated by the CAM-ICU scores up to 14 days after ICU admission. |
|
| Measure | Description | Time Frame |
|---|---|---|
| AUROC for PRE-DELIRIC | Area Under the Receiver Operating Characteristics (AUROC) for PRE-DELIRIC | Duration of the study, november 2021 to september 2022 |
| AUROC for E-PRE-DELIRIC | Area Under the Receiver Operating Characteristics (AUROC) for E-PRE-DELIRIC | Based on 14 days of ICU admission |
| Measure | Description | Time Frame |
|---|---|---|
| 30-days mortality | Dead or alive at day 30 after ICU admission | 30 days efter ICU admission |
| Time on ventilator | Days in need of mechanical ventilation up to 14 days of ICU admission |
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Inclusion Criteria:
Exclusion Criteria:
Male or female
All adult patients admitted to participating ICUs in the Zealand Region between November 2021 and July 2022.
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| Name | Affiliation | Role |
|---|---|---|
| Neeliya Anton Joseph, BSc Medicine | Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zealand University Hospital, Department of Anaesthesiology | Køge | Zealand Region of Denmark | 4600 | Denmark |
Individual anonymised participant data will be made available to researchers upon reasonable request after termination and publication of the study.
After the termination and publication of the study
Reasonable request by researcher based on study protocol.
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| ID | Term |
|---|---|
| D003693 | Delirium |
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D003221 | Confusion |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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|
| 14 days after ICU admission |
| ICU length of stay | Days in the ICU up to 30 days | 30 days after ICU admission |
| Hospital length of stay | Days in the hospital up to 30 days after ICU admission | 30 days after ICU admission |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |