TY - JOUR

T1 - Delirium prevalence and prevention in patients with acute brain injury

T2 - A prospective before-and-after intervention study

AU - Larsen, Laura Krone

AU - Møller, Kirsten

AU - Petersen, Marian

AU - Egerod, Ingrid

PY - 2020

Y1 - 2020

N2 - Objectives: Knowledge regarding delirium prevention in patients with acute brain injury remains limited. We tested the hypothesis that an intervention bundle which targeted sedation, sleep, pain, and mobilisation would reduce delirium in patients with acute brain injury. Design: A prospective before-after intervention study: a five-month phase of standard care was followed by a six-month intervention phase. Setting: The neuro-intensive care unit, University Hospital of Copenhagen, Denmark. Main outcome measures: The Intensive Care Delirium Screening Checklist was used to detect delirium. Primary outcome was delirium duration; secondary outcomes were delirium prevalence, ICU length of stay and one year mortality. Results: Forty-four patients were included during the standard care phase, and 50 during the intervention phase. Delirium was present in 90% of patients in the standard care group and 88% in the intervention group (p = 1.0), and time with delirium was 4 days vs 3.5 days (p = 0.26), respectively. Also, ICU length of stay (13 vs. 10.5 days (p = 0.4)) and the one year mortality (21% vs 12% (p = 0.38))) were similar between groups. Conclusion: We found a high prevalence of delirium in patients with acute brain injury. The intervention bundle did not significantly reduce prevalence or duration of delirium, ICU length of stay or one year mortality.

AB - Objectives: Knowledge regarding delirium prevention in patients with acute brain injury remains limited. We tested the hypothesis that an intervention bundle which targeted sedation, sleep, pain, and mobilisation would reduce delirium in patients with acute brain injury. Design: A prospective before-after intervention study: a five-month phase of standard care was followed by a six-month intervention phase. Setting: The neuro-intensive care unit, University Hospital of Copenhagen, Denmark. Main outcome measures: The Intensive Care Delirium Screening Checklist was used to detect delirium. Primary outcome was delirium duration; secondary outcomes were delirium prevalence, ICU length of stay and one year mortality. Results: Forty-four patients were included during the standard care phase, and 50 during the intervention phase. Delirium was present in 90% of patients in the standard care group and 88% in the intervention group (p = 1.0), and time with delirium was 4 days vs 3.5 days (p = 0.26), respectively. Also, ICU length of stay (13 vs. 10.5 days (p = 0.4)) and the one year mortality (21% vs 12% (p = 0.38))) were similar between groups. Conclusion: We found a high prevalence of delirium in patients with acute brain injury. The intervention bundle did not significantly reduce prevalence or duration of delirium, ICU length of stay or one year mortality.

KW - Brain injuries

KW - Critical care

KW - Critical care nursing

KW - Delirium

KW - Intensive care units

KW - Neuroscience nursing

KW - Prevention

U2 - 10.1016/j.iccn.2020.102816

DO - 10.1016/j.iccn.2020.102816

M3 - Journal article

C2 - 32089416

AN - SCOPUS:85079847978

VL - 59

JO - Intensive and Critical Care Nursing

JF - Intensive and Critical Care Nursing

SN - 0964-3397

M1 - 102816

ER -