Saratov JOURNAL of Medical and Scientific Research

Prognostic significance of delirium in the intensive care period of acute myocardial infarction

Year: 2016, volume 12 Issue: в„–1 Pages: 36-39
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Yulin A.S., Ermakov M.A., Gavrilova E.S., Astakhov A.A.
Organization: South Ural State Medical University

The aim: to identify the frequency and clinical features of delirium in acute myocardial infarction (AMI) in the conditions of the intensive care unit. Material and Methods. The study involved 104 patients (43,3% women and 56,7% men) with AMI during the stay at the intensive care unit. The average age was 68,0 [59,0-76,7] years. Delirium was diagnosed using the criteria questionnaire Moss-ICU. For neurodevelopmental testing we used screening tests and rating scales. Results. The incidence of delirium in patients in this category was 28,8%. Most frequently delirium develops in patients aged 60-89 years: in the age group 60-74 years 25,0%, in the group of 75-89 years 44,7%. Delirium developed in the 1-2 day stay in the intensive care unit and intensive care. The average duration of delirium was 7,7 days. Hypoproductive form of delirium was detected in 64,3% of all cases, hyperproductive form in 21,4% of patients, mixed form in 14,2% of patients. The occurrence of delirium is associated with an increase of the duration of stay at the intensive care unit at 6 times compared with patients without delirium. Conclusion. The presence of delirium greatly increases the probability of death in the reanimation period of acute myocardial infarction. Moss questionnaire and training of doctors to work with rating scales should be accepted in all ICU intensive care units for early diagnosis of delirium and immediate correction of disorders of consciousness in patients in critical condition.

1. Patel RP, Gambrell M, Speroff T, et al. Delirium and sedation in the intensive care unit: Survey of behaviors and attitudes of 1384 healthcare professionals. Crit Care Med 2009; 37 (3): 825-832
2. Maksimov A.l. Deliry in the sharp period of a Q-myocardial infarction. Sibirskij medicinskij zhurnal 2011; 26 (1): 58-63
3. Zabolotskih I.B., Pesnjak E.V. Sedation in intensive therapy. Petrozavodsk: IntelTek, 2007; 79 p.
4. Sapozhnikov A.N., Sabitov I.A., Shcherbakova I.G., et al. On the question of the prognostic value of psychopathological disorders in vascular encephalopathy in patients with acute myocardial infarction. Basic Research 2013; (7): 633-637
5. Nacional'nye rekomendacii СЂРѕ diagnostike i lecheniju bol'nyh ostrym infarktom miokarda s podemom segmenta ST JeKG. Kardiovaskuljarnaja terapija i profilaktika 2007; 6 (8) Supplement 1
6. Stawicki SP, Gerlach AT. Delirium assessment in the intensive care unit: An overview of objective diagnostic criteria and scoring tools: OPUS 12. Scientist 2008; 2 (4): 13-16
7. Ely EW, Margolin R, Francis J, etal. Evaluation of delirium in critically ill patients: validation of the confusion assessment method for the Intensive Care Unit (CAM-ICU). Crit Care Med 2001; 29 (7): 1370-1379
8. Zamjatin M.N., Gorohovatskij J.l., Vahljaev A.V. Diagnostika delirija u pacientov v otdelenijah reanimacii i intensivnoj terapii: Uchebno-metodicheskoe posobie. M., 2014; 26 p.
9. Sessler Curtis N., Gosnell Mark S., et al. The Richmond Agitation-Sedation Scale: Validity and Reliability in Adult Intensive Care Unit Patients. Am J Respir Crit Care Med 2002; 166: 1338-1344
10. Maegher D. Delirium: the role of psychiatry /The Royal College of Psychiatrists. Advance in Psychiatric Treatment 2001; 7: 433-443.

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