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Pensar Enfermagem / v.28 n.sup / October 2024
DOI: 10.71861/pensarenf.v28iSup.386
Abstract
Introduction
Delirium is an independent predictor of mortality, morbidity, increased length of stay and
long-term cognitive impairment, with a negative impact on the critically ill patient and their
family.1 There are few studies on critically ill burn patients, and it is estimated that the
incidence of delirium in this population can reach 77%.2,3 This study is part of the
cognition.id sub-project, as part of the id.Care project.
Objective
To determine the incidence and risk factors of delirium in burn patients under mechanical
ventilation.
Methods
Observational, analytical cohort study between August 2022 and January 2024. The scale
Confusion Assessment Method for the Intensive Care Unit was applied at least twice a day.
A data collection instrument was created, with variables to characterize the sample,
comorbidities and possible risk factors. People who did not require mechanical ventilation,
whose cause of admission was not burns or who were not assessed for delirium were
excluded. The study was approved by the Ethics Committee.
Results
The mechanism of burn injury in 92.6% of the 27 participants was thermal in origin, with
total body surface area (TBSA) between 2%-92% (average 24%). On average, they were
ventilated for 14 days, with 21 requiring surgery and 18 developing systemic infections. The
incidence of delirium in this study was 81.5%, with an average duration of 11.86 days, and
with its development on average on the 12th day of hospitalization. Risk factors for
developing delirium are systemic infection, TBSA and surgical intervention.
Conclusion
The incidence of delirium is high in burn patients under mechanical ventilation. Predictors
of the development of delirium highlight the importance of considering factors unique to
this population to minimize its impact, particularly in the management and control of burn
infection.
Keywords
Delirium, Risk Factors, Burns, Comorbidity.
References
1. Dziegielewski C, Skead C, Canturk T, Webber C, Fernando SM, Thompson LH, et al.
Delirium and Associated Length of Stay and Costs in Critically Ill Patients. Tran QK, editor.
Crit Care Res Pract [Internet]. 2021 [cited 2024 May 27]; 1–8. Available from:
https://www.hindawi.com/journals/ccrp/2021/6612187/
2. Agarwal V, O’Neill PJ, Cotton BA, Pun BT, Haney S, Thompson J, et al. Prevalence and
risk factors for development of delirium in burn intensive care unit patients. J Burn Care Res
[Internet]. 2010 [cited 2024 May 27]; 31(5):706–15. Available from:
https://pubmed.ncbi.nlm.nih.gov/20647937/
3. van Yperen DT, Raats JW, Dokter J, Ziere G, Roukema GR, Van Baar ME, et al.
Prevalence and Risk Factors for Delirium in Elderly Patients with Severe Burns: A
Retrospective Cohort Study. J Burn Care Res [Internet]. 2020 [cited 2024 May 27];
41(2):371–6. Available from: https://pubmed.ncbi.nlm.nih.gov/31504611/
Incidence of Delirium in Ventilated Burn Patients: a
Cohort Study
Márcia Pereira Silva1
orcid.org/0000-0001-7055-8665
Joana Vala2
orcid.org/0009-0008-7256-0548
Joana Teixeira3
orcid.org/0000-0001-9237-8120
Helga Rafael Henriques4
orcid.org/0000-0003-2946-4485
João Sousa5
1Burn Unit, Unidade Local de Saúde de Santa Maria,
Lisbon. Nursing Research, Innovation and
Development Centre of Lisbon (CIDNUR), Lisbon,
Portugal.
2 Burn Unit, Unidade Local de Saúde de Santa Maria,
Lisbon, Portugal.
3Nursing School of Lisbon, Lisbon. Nursing Research,
Innovation and Development Centre of Lisbon
(CIDNUR), Lisbon, Portugal.
4Nursing School of Lisbon, Lisbon. Nursing Research,
Innovation and Development Centre of Lisbon
(CIDNUR), Lisbon, Portugal.
5Urology Department, Unidade Local de Saúde de
Santa Maria, Lisbon, Portugal.
Corresponding author:
Márcia Pereira Silva
E-mail: aureliams84@gmail.com
