Role of Quetiapine in the Prevention of ICU Delirium in Elderly Patients at a High Risk

Fig. 1.

Demographics and clinical parameters of patients among the two groups

	Group Q	Group C	P value
Age [mean ± SD]	68.7 ± 7.6	71.2 ± 5.7	0.02
Gender [n (%)]
Male	19 (42%)	15 (33%)	0.38
Female	26 (58%)	30 (67%)
Co-morbidities [n (%)]
Respiratory diseases	4 (9%)	5 (11%)	0.5
Metabolic diseases	2 (5%)	8 (18%)
Cardiac diseases	16 (36%)	17 (37%)
Neurological diseases	2 (4%)	0 (0%)
Multiple	20 (44%)	15 (34%)
qSOFA Score [median (IQR)]	3 (1–6)	3 (1–4)	0.0001
Length of hospital stay [median (IQR)]	15 (10–19)	10 (5–14)	0.001

Intensive care delirium screening checklist (ICDSC)

Main item	Subitem
1. Altered level of consciousness:	A: No response
	B: Response to intense and repeated stimulation
	C: Response to mild or moderate stimulation
	D: Normal wakefulness
	E: Exaggerated response to normal stimulation
2. Inattentiveness:	Difficulty following instructions or easily distracted
3. Disorientation To time, place, or person
4. Hallucination-delusion-psychosis:	Clinical manifestation or suggestive behavior
5. Psychomotor agitation or retardation:	Agitation requiring use of drugs or restraints, or slowing
6. Inappropriate speech or mood:	Related to events or situation, or incoherent speech
7. Sleep/wake cycle disturbance:	Sleeping < 4hrs day, walking all the night, sleeping all day
8. Symptom fluctuation Symptoms above occurring intermittently

Risk factors for ICU delirium among the two groups

	Group Q	Group C	P value
Immobilization [n (%)]	37 (82%)	21 (47%)	0.0004
Urinary catheter [n (%)]	33 (73%)	26 (58%)	0.12
Infection [n (%)]	37 (82%)	19 (42%)	0.0001
Visual Impairment [n (%)]	8 (18%)	23 (51%)	0.0008
Auditory impairment [n (%)]	11 (24%)	17 (38%)	0.17
Hemoglobin [gm/dl, mean ± SD]	9.7 ± 1.8	9.6 ± 1.5	0.13
Analgesic & Sedative [n (%)]	17 (38%)	16 (36%)	0.83
Shocked [n (%)]	8 (18%)	9 (20%)	0.78
Intubated [n (%)]	2 (4%)	0 (0%)	0.25
Metabolic abnormalities [n (%)]	40 (89%)	34 (76%)	0.09

Comparison between the cases presented with delirium among the two groups

		Group Q N (%)	Group C N (%)	P value
Delirium	No	34 (75%)	23 (51%)	0.01
	Hypoactive	9 (20%)	5 (11%)
	Hyperactive	2 (5%)	17(38%)

CAM-ICU-7 and ICDSE scores among the two groups

	Group Q			Group C			P value
	Min	Max	Median (IQR)	Min	Max	Median (IQR)
CAM-ICU-7	0	7	2 (0–3)	0	7	2 (0–6)	0.37
ICDSC	0	7	0 (0–2)	0	7	0 (0–4)	0.06