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Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients
Pandharipande P, Cotton BA, Shintani A, Thompson J, Pun BT, Morris JA, Dittus R, Ely EW.. The Journal of trauma, 2008-07-01
Topic: Risk, prevention and care in population studies
Plain-language summary
Background Although known to be an independent predictor of poor outcomes in medical intensive care unit (ICU) patients, limited data exist regarding the prevalence of and risk factors for delirium among surgical (SICU) and trauma ICU (TICU) patients. The purpose of this study was to analyze the prevalence of and risk factors for delirium in surgical and trauma ICU patients. Methods SICU and TICU patients requiring mechanical ventilation (MV) >24 hours were prospectively evaluated for delirium using the Richmond Agitation Sedation Scale (RASS) and the Confusion Assessment Method for the ICU (CAM-ICU). Those with baseline dementia, intracranial injury, or ischemic/hemorrhagic strokes that would confound the evaluation of delirium were excluded. Markov models were used to analyze predictors for daily transition to delirium. Results One hundred patients (46 SICU and 54 TICU) were enrolled. Prevalence of delirium was 73% in the SICU and 67% in the TICU. Multivariable analyses identified midazolam [OR 2.75 (CI 1.43-5.26, p = 0.002)] exposure as the strongest independent risk factor for transitioning to delirium. Opiate exposure showed an inconsistent message such that fentanyl was a risk factor for delirium in the SICU (p = 0.007) but not in the TICU (p = 0.936), whereas morphine exposure was associated with a lower risk of delirium (SICU, p = 0.069; TICU p = 0.024). Conclusion Approximately 7 of 10 SICU and TICU patients experience delirium. In keeping with other recent data on benzodiazepines, exposure to midazolam is an independent and potentially modifiable risk factor for the transitioning to delirium.
What this study adds
Evidence grade: Low
This study found that delirium was common in surgical and trauma intensive care unit patients and that midazolam exposure was the strongest risk factor for transitioning to delirium. Reported effect size: OR 2.75.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Pandharipande, P., Cotton, B. A., Shintani, A., Thompson, J., Pun, B. T., Morris, J. A., et al. (2008). Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. The Journal of trauma. https://doi.org/10.1097/ta.0b013e31814b2c4d
Vancouver
Pandharipande P, Cotton BA, Shintani A, Thompson J, Pun BT, Morris JA, et al. Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. The Journal of trauma. 2008. doi:10.1097/ta.0b013e31814b2c4d. PMID: 18580517.
BibTeX
@article{pandharipande2008-18580517,
author = {Pandharipande, P. and Cotton, B. A. and Shintani, A. and Thompson, J. and Pun, B. T. and Morris, J. A. and Dittus, R. and Ely, E. W.},
title = {{Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients}},
journal = {The Journal of trauma},
year = {2008},
doi = {10.1097/ta.0b013e31814b2c4d},
pmid = {18580517},
url = {https://doi.org/10.1097/ta.0b013e31814b2c4d}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results One hundred patients (46 SICU and 54 TICU) were enrolled.
- Opiate exposure showed an inconsistent message such that fentanyl was a risk factor for delirium in the SICU (p = 0.007) but not in the TICU (p = 0.936), whereas morphine exposure was associated with a lower risk of delirium (SICU, p = 0.069; TICU p = 0.024).
Why it matters
This study found that delirium was common in surgical and trauma intensive care unit patients and that midazolam exposure was the strongest risk factor for transitioning to delirium. It concerns delirium in critically ill patients and does not test any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Effect sizeOR 2.75
- Evidence strengthLow
How this study scored 51/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Journal of trauma) |
| Journal's citation record | 3 / 4 | The Journal of Trauma: Injury, Infection, and Critical Care: journal h-index 253 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 556 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 27.8 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 4 / 6 | Cited 18.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 45 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Eugene Wesley Ely: h-index 135 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Vanderbilt University: institution h-index 1,199 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18580517) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 51 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1097/ta.0b013e31814b2c4d
- PubMed: 18580517
- Original source →
- Free full text: PubMed Central →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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