Delirium in Older People Admitted to the Intensive Care Unit and Its Association with Mechanical Restraint

Abstract

Introduction: Advanced age is one of the most prevalent predisposing factors in cases of delirium, particularly in older patients hospitalized in intensive care units. Due to population aging and demographic transition, this study presents a specific sample analysis of a population subgroup. Objectives: To determine the prevalence of delirium in older patients hospitalized in the intensive care unit and to verify correlations with clinical and sociodemographic predictor variables. Materials and Methods: This is a cross-sectional study conducted in the countryside of the state of Pernambuco, Brazil, between July and November 2023. Older people aged 60 years or older (according to Brazilian law) and hospitalized for at least 24 hours were included. The Richmond Agitation-Sedation Scale (RASS) was used to screen sedation levels, and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was used to assess delirium. Results: The sample consisted of 83 older patients hospitalized in the intensive care unit. The prevalence rate of delirium was 36.1 %, with a strong association with the predictor “use of mechanical restraint in bed”. Multivariate analysis showed that the use of mechanical restraint in bed increases the odds of delirium in older people by 21.5 times (OR = 21.542; 95 % CI: 6.663-69.641). Conclusions: Reducing the use of mechanical restraint, adequately monitoring sedation, and preventing delirium are essential strategies for reducing healthcare costs and providing a more humane experience for patients and their families.