Role of Quetiapine in the Prevention of ICU Delirium in Elderly Patients at a High Risk
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31 oct 2024
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Categoría del artículo: Research Article
Publicado en línea: 31 oct 2024
Páginas: 361 - 367
Recibido: 26 oct 2023
Aceptado: 10 jul 2024
DOI: https://doi.org/10.2478/jccm-2024-0032
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© 2024 Walid Y. Kamel et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Fig. 1.
Demographics and clinical parameters of patients among the two groups
| 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)
| 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
| 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
| 34 (75%) | 23 (51%) | 0.01 | ||
| 9 (20%) | 5 (11%) | |||
| 2 (5%) | 17(38%) | |||
CAM-ICU-7 and ICDSE scores among the two groups
| 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 |