Browsing by Subject "critical illness"

Background: Delirium is a common, under-diagnosed and serious problem among critically ill patients. Episodes of delirium are associated with a number of adverse outcomes; it seems to carry a considerable risk for future complications, increased future morbidity, long-term impairments in cognitive abilities, and even death. Approximately 80% of patients in intensive care unit (ICU) will develop delirium during their stay in hospital, making it to be a rather common condition – especially among elderly patients. With aging of the patient population in ICU incidence of delirium is likely to increase in future. Early recognition, prevention and treatment for delirium in and after ICU is extremely important for future recovery. There is promising evidence suggesting that delirium could be used as an effective tool for predicting future recovery and health complications after release from ICU. Aim of the study: To identify adverse consequences of post-operative delirium (POD) in ICU (with main focus on future cognitive decline), recognize possible risk groups and current screening and treatment procedures. Methods: A systematic review was conducted, following the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature was collected between September and October 2019 from PubMed ja Ovid Medline data bases using keywords ’delirium’, ’critical illness’, ’consequences’, ’effects’,’cognitive decline’, and ’cognitive impairments’. The search yielded 23 peer reviewed articles which are included in this revies. Results: Episodes of non-dementia delirium in ICU were associated with a number of health complications, prolonged hospital stay and higher risk for readmissions, higher morbidity and mortality, increased risk of falls, accident and injuries, social problems, increased stress and distress, cognitive impairments and increased risk for developing dementia. Different subtypes of delirium (hypoactive vs. hyperactive) seemed to lead to somewhat different adverse consequences; however, all recognized subtypes were hazardous. Conclusions: Delirium is a common, severe and under-diagnosed health problem among ICU patients. It has shown to be associated with various adverse outcomes that create serious economical costs for both individuals and societies, as well as significantly impair patients’ health and later quality of life. Episodes of ICU delirium can cause cognitive impairments and accelerate cognitive decline associated with neuropsychiatric disorders (such as dementia). Although the majority of healthcare professionals acknowledge the severity of problem, the current procedures for prevention, treatment, screening and monitoring are severely lacking. Both current screening tools and training of medical staff are in dire need for improvements.