Vojnosanitetski pregled 2016 Volume 73, Issue 9, Pages: 838-843
https://doi.org/10.2298/VSP141212012S
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Markers of inflammation as risk predictors of lethal outcome in patients diagnosed with delirium
Stašević-Karličić Ivana (Clinic for Psychiatric Disorders “Dr Laza Lazarević”, Belgrade)
Stašević Milena (Clinic for Psychiatric Disorders “Dr Laza Lazarević”, Belgrade)
Janković Slobodan (Clinic for Pharmacology, Toxicology and Clinical Pharmacology, Kragujevac + Faculty of Medical Sciences, Kragujevac)
Đukić-Dejanović Slavica (Clinic for Psychiatric Disorders “Dr Laza Lazarević”, Belgrade + Faculty of Medical Sciences, Kragujevac)
Milovanović Srđan (Clinical Center of Serbia, Clinic for Psychiatry, Belgrade + Faculty of Medicine, Belgrade)
Background/Aim. Delirium is an acute or subacute, and most frequently
reversible syndrome of higher cortical functions disturbances that is
manifested as generalized disorder. If not prevented, it is associated with
various adverse outcomes. The aim of this study was to determine the
connection between the markers of inflammation and lethal outcome in patients
diagnosed with delirium, hospitalized in the psychiatric intensive care unit.
Methods. This retrospective study included 120 patients hospitalized in the
psychiatric intensive care unit in whom examination of differences in
inflammation markers was done. The examinees have been divided into two
groups: the case group of 40 patients who died during the hospitalization,
and the control group of 80 examinees who were discharged with the diagnosis
Post delirium status. The following variables were taken into account: age,
gender, clinical diagnosis of infection (pneumonia and urinary tract
infection), laboratory parameters (total of white blood cells, granulocytes,
monocytes, C-reactive protein − CRP) and type of delirium (withdrawal or
organic). Results. The average age of patients was 50.3 ± 13.1 years. The
patients who survived delirium, were on the average 10.5 years younger than
the deceased (p < 0.001). More than half (57.5%) of the deceased had
pneumonia. There was a statistically significant correlation between
pneumonia and lethal outcome in the patients with delirium (p < 0.001). The
examinees with lethal outcome had significantly higher median CRP levels than
the group of examinees who survived (75.6% ± 54.0 vs 30.3 ± 42.5 ng/L, p <
0.001). Conclusion. Aiming to better and more precise diagnostics of this
complicated and still unclear neuropsychiatric syndrome it would be useful to
consider introduction of more precise diagnostic algorithms in every unit of
intensive care. That would significantly reduce the number of delirium
diagnosis overlook, decrease complication of clinical features and would also
reduce the unfavorable outcome rate, therefore the total cost of treatment.
Keywords: delirium, intensive care units, inflammation, biological markers, c-reactive protein, prognosis