DELIRIUM IN PATIENTS WITH ACUTE CORONARY SYNDROMES: PREVALENCE, RISK FACTORS AND OUTCOMES
Introduction. Delirium is one of the most common and serious complications in critically ill patients. The goal of this study was to establish the prevalence, risk factors and outcomes of delirium in patients with acute coronary syndromes (ACS). Material and methods. The study included 454 patients with ACS admitted in an intensive care unit (ICU). Seventy-nine percent of patients were presented with ACS with ST-segment elevation, 21% - with ACS without ST segment elevation. Mean age was 60 ± 10 years; men were the majority of the sample (77%). ICU-CAM and RASS scores were used as a delirium monitoring instruments. The study sample was divided into two subgroups depending on the presence or absence of delirium which were compared onseveral clinical, demographic, laboratory and instrumentalcharacteristics. Results. Delirium occurred in 50 patients (11%). Elderly age (68 ± 10 years in the delirium subgroup versus 59 ± 9 years in the control subgroup, р < 0.0001), chronic or acute alcohol abuse (23% vs. 7%, р < 0.001), anemia (24% vs. 6%, р < 0.0001) and pneumonia (16% vs. 1%, р < 0.0001) have become the main predictors of this complication. Cardiogenic shock (14% vs. 3%,р < 0.001), low left ventricle ejection fraction (47 ± 12% vs.52 ± 9%, р < 0.001), history of myocardial infarction(26% vs. 15%, р < 0.05) and stroke or transient ischemic attack (13% vs. 5%, р < 0.05), renal dysfunction (52% vs. 31%, p < 0.01)were also linked to a delirium but less significant. Delirium was associated with increased length of stay in ICU (7.5 days vs.3.3 days, р < 0.0001), greater rates of deep sedation andmechanical ventilation (18% vs. 0.3%, р < 0.0001), infectious complications (8% vs. 0%, р < 0.0001), mortality (4% vs. 0.7%,р < 0.05) and higher cost of treatment.