Delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation: a prospective cohort study

Abstract

Background: COPD combined with respiratory failure is very common in intensive care unit (ICU). We aimed to evaluate the current status and influencing factors of delirium in elderly COPD patients with undergoing mechanical ventilation. Methods: Patients with COPD combined with respiratory failure and mechanically ventilated who were admitted to the ICU of our hospital were selected. The characteristics of included patients were assessed. Pearson correlation analysis was performed to evaluate the characteristics of patients and delirium. Logistic regression analysis was conducted to identify the risk factors of delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation. Results: A total of 237 COPD combined with respiratory failure patients were included, the incidence of delirium was 21.94%. Pearson correlation analysis indicated that age (r = 0.784), BMI (r = 0.709), hypertension (r = 0.696), APACHE II score (r = 0.801), CPOT (r = 0.513), sedation(r = 0.626) and PaO2 (r = 0.611) were all correlated with the occurrence of delirium (all p < 0.05). Logistic regression analysis indicated that age ≥ 75y (OR 3.112, 95% CI 2.144–4.602), BMI ≤ 19 kg/m2 (OR 2.742, 95% CI 1.801–3.355), hypertension(OR 1.909, 95% CI 1.415–2.421), APACHE II score ≥ 15 (OR 2.087, 95% CI 1.724–2.615), CPOT ≥ 5 (OR 1.778, 95% CI 1.206–2.641), sedation(OR 3.147, 95% CI 2.714–3.758), PaO2 ≤ 75 mmHg(OR 2.196, 95%CI 1.875–3.088) were the risk factors of delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation (all p < 0.05). Conclusions: Delirium is common in patients with COPD and respiratory failure undergoing mechanical ventilation, and there are many related influencing factors. Medical staff should pay more attention to patients with risk factors and take intervention measures as soon as possible to reduce the incidence of delirium.