Abstract
Delirium represents a common complication in critically ill patients and impacts in-hospital mortality in patients with pneumonia. The aim of the study was to evaluate the prevalence of delirium symptoms during hospitalization in patients with severe pneumonia and their impact on one-year mortality. This was an observational, retrospective, cohort study of consecutive patients admitted to a respiratory high dependency unit with a diagnosis of severe pneumonia. A search through the charts looking for ten key words associated with delirium (confusion, disorientation, altered mental status, delirium, agitation, inappropriate behavior, mental status change, inattention, hallucination, lethargy) was performed. A total of 172 patients were enrolled (78% males; median age: 75 years). At least one delirium symptom was detected in 53 patients (31%) during hospitalization. The prevalence of delirium symptoms during hospitalization was higher among those who died during hospitalization vs. those who survived (44% vs. 27%, p=0.049, respectively). A total of 71 patients (46%) died during one-year follow-up after the diagnosis of pneumonia. At the multivariable logistic regression analysis, after adjustment for age, comorbidities and severe sepsis, the presence of at least one delirium symptom during hospitalization was an independent predictor of one-year mortality (OR: 2.35; 95%CI: 1.13-4.90; p=0.023). Further prospective clinical studies should evaluate delirium as independent predictor of adverse outcomes in patients with pneumonia and include it into risk scores for stratification.
- © 2014 ERS
