Page 320 - GHR_NursingCMU2024_Final.indd

The Incidence and Predictors of Intensive Care Unit Delirium in Older Adults with
Chronic Kidney Disease: A Hospital-based, Retrospective, Observational Study

H. Chiu and S. Guo 2
1

1 2
School of Nursing, College of Nursing, Taipei Medical University, Chinese Taipei, and Department of
Nursing, Taipei Medical University Hospital, Chinese Taipei

Background: Under recognition of delirium is a major problem in older people with chronic kidney
disease (CKD) admitted to intensive care units (ICUs), which may cause prolonged stay of ICU and
higher mortality.

Objective: To explore the incidence and risk factors of ICU delirium in older people with CKD.

Methods: This was a retrospective observational study. We derived the relevant data between January
2021 and August 2022 from the health medical records of the Taipei Medical University Hospital. Older adults
admitted to three ICUs at the hospital and diagnosed with CKD were included as a case-cohort group.
Age- and gender-matched control cohorts were randomly selected from the dataset. The episode of ICU
delirium was assessed using the Intensive Care Delirium Screening Checklist score of ≥ 4. The secondary
outcomes consisted of the lengths of mechanical ventilation use and ICU stay. Multivariable logistic
regression was used to identify the risk factors of ICU delirium in older adults with CKD.

Results: A total of 657 older adults diagnosed with CKD were included, with an average age of 80.58 years;
57.2% of them were male. Out of these, 423 cases (64.4%) developed ICU delirium. Multivariable logistic
regression analysis identified older age (Odds ratio = 1.04), dementia (2.16), speech impairment (2.99),
physical restraints (3.63), CRP levels (1.03), and albumin levels (1.21) as independent predictors of ICU
delirium onset in geriatric CKD patients (all P < 0.05).

Conclusion: We suggest that older age, dementia, speech impairment, physical restraints, and
specific biochemical markers are critical independent predictors of ICU delirium onset in geriatric
CKD patients. These insights highlight the need for heightened vigilance and tailored preventive
strategies in managing ICU delirium, particularly in older adults with CKD. By addressing these key
factors, healthcare providers can improve patient outcomes and enhance the quality of care in the
critical care setting.

Keywords: intensive care unit, delirium, chronic kidney disease

_____________________________________________________________________________________________________
Correspondence: Hsiao-Yean Chiu, School of Nursing, College of Nursing, Taipei Medical University,
Poster Presentation Abstracts
Chinese Taipei
E-mail: hychiu0315@tmu.edu.tw

318