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ImpRovIng CaRdIaC SuRgeRy outComeS

Critical Care Medicine(2013)

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摘要
members of the study team, received formal delirium education and training and served as the validated CAM-ICU RN team. Eligible NTICU patients were assessed once daily utilizing the CAM-ICU tool. Results: In total 117 patients were screened for delirium. Demographic characteristics included: male 51% (n=60), 49% female (n=57); age 18-94 years (60.21 ± 20.55); Acute Physiology and Chronic Health Evaluation (APACHE) IV admission score 0.95-63.37 (15.32 ± 13.68); history of dementia 6% (n=7), alcohol abuse 3% (n=4), hypertension 43% (n=51), non-traumatic brain injury 12% (n=14), and TBI 39% (n=45). Sixty patients (49%) demonstrated CAM-ICU positive delirium during their NTICU admission. Of the 32 patients with both CAM negative and CAM positive scores, 16 (50%) went from a CAM negative to a CAM positive during some point in their stay. Sex, age, history of hypertension, and non-traumatic brain injury were not correlated with CAM positive delirium (p≥.05). Conclusions: The CAM-ICU tool was successfully implemented in our NTICU. This study supports prior studies suggesting patients with history of mechanically ventilation, TBI, benzodiazepine treatment, low GCS on admission, and periods of low conscious arousal are at high-risk for Delirium; however, significance was not found in the Neurosurgical non-TBI subgroup (≥.05). Delirium incidence patterns in our NTICU will assist our interdisciplinary team to identify at risk patients and implement early prevention strategies.
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