Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study

Elke Berger; Evert-Jan Wils; Piet Vos; Susanne van Santen; Jeroen Koets; Arjen J C Slooter; Meta van der Woude; Matty Koopmans; Martin A Rinket; Oscar Hoiting; Emma E Hoogendoorn; Jörn O Streefkerk; Els W de Vreede; Bea Riekerk; Koen S Simons; Eryk Toscano; F Jeannette Schoonderbeek; Lieuwe S Hofstra; Huub L A van den Oever; Adrienne M T J Raben; Susanne Holman; Fleur Nooteboom; Carina Bethlehem; Julia Ten Cate; Martijn Verkade; Lisa Mijzen; Janneke M de Man-van Ginkel; Hester Vermeulen; Mark van den Boogaard

doi:10.1016/j.iccn.2020.102925

Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study

Elke Berger, Evert-Jan Wils, Piet Vos, Susanne van Santen, Jeroen Koets, Arjen J C Slooter, Meta van der Woude, Matty Koopmans, Martin A Rinket, Oscar Hoiting, Emma E Hoogendoorn, Jörn O Streefkerk, Els W de Vreede, Bea Riekerk, Koen S Simons, Eryk Toscano, F Jeannette Schoonderbeek, Lieuwe S Hofstra, Huub L A van den Oever, Adrienne M T J RabenSusanne Holman, Fleur Nooteboom, Carina Bethlehem, Julia Ten Cate, Martijn Verkade, Lisa Mijzen, Janneke M de Man-van Ginkel, Hester Vermeulen, Mark van den Boogaard

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

OBJECTIVES: This study aimed to determine the prevalence, risk factors of delirium and current practice of delirium management in intensive care units of various levels of care.

RESEARCH METHODOLOGY/DESIGN: Prospective multicentre cohort study.

SETTING: In all adult patients admitted to one of the participating intensive care units on World Delirium Awareness Day 2018, delirium point and period prevalence rates were measured between ICU admission and seven days after the index day.

RESULTS: In total, 28 (33%) Dutch intensive care units participated in this study. Point-prevalence was 23% (range 41), and period-prevalence was 42% (range 70). University intensive care units had a significantly higher delirium point-prevalence compared with non-university units (26% vs.15%, p = 0.02). No significant difference were found in period prevalence (50% vs. 39%, p = 0.09). Precipitating risk factors, infection and mechanical ventilation differed significantly between delirium and non-delirium patients. No differences were observed for predisposing risk factors. A delirium protocol was present in 89% of the ICUs. Mean delirium assessment compliance measured was 84% (±19) in 14 units and estimated 59% (±29) in the other 14.

CONCLUSION: Delirium prevalence in Dutch intensive care units is substantial and occurs with a large variation, with the highest prevalence in university units. Precipitating risk factors were more frequent in patients with delirium. In the majority of units a delirium management protocol is in place.

Original language	English
Article number	102925
Journal	Intensive & Critical Care Nursing
Volume	61
DOIs	https://doi.org/10.1016/j.iccn.2020.102925
Publication status	Published - Dec 2020

Bibliographical note

Keywords

Adult
Cohort Studies
Critical Care
Critical Care Nursing
Delirium
Humans
Intensive Care Units
Netherlands
Prevalence
Prospective Studies
Risk Factors

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Berger, E., Wils, E-J., Vos, P., van Santen, S., Koets, J., Slooter, A. J. C., van der Woude, M., Koopmans, M., Rinket, M. A., Hoiting, O., Hoogendoorn, E. E., Streefkerk, J. O., de Vreede, E. W., Riekerk, B., Simons, K. S., Toscano, E., Schoonderbeek, F. J., Hofstra, L. S., van den Oever, H. L. A., ... van den Boogaard, M. (2020). Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study. Intensive & Critical Care Nursing, 61, [102925]. https://doi.org/10.1016/j.iccn.2020.102925

Berger, Elke ; Wils, Evert-Jan ; Vos, Piet ; van Santen, Susanne ; Koets, Jeroen ; Slooter, Arjen J C ; van der Woude, Meta ; Koopmans, Matty ; Rinket, Martin A ; Hoiting, Oscar ; Hoogendoorn, Emma E ; Streefkerk, Jörn O ; de Vreede, Els W ; Riekerk, Bea ; Simons, Koen S ; Toscano, Eryk ; Schoonderbeek, F Jeannette ; Hofstra, Lieuwe S ; van den Oever, Huub L A ; Raben, Adrienne M T J ; Holman, Susanne ; Nooteboom, Fleur ; Bethlehem, Carina ; Ten Cate, Julia ; Verkade, Martijn ; Mijzen, Lisa ; de Man-van Ginkel, Janneke M ; Vermeulen, Hester ; van den Boogaard, Mark. / Prevalence and management of delirium in intensive care units in the Netherlands : An observational multicentre study. In: Intensive & Critical Care Nursing. 2020 ; Vol. 61.

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title = "Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study",

abstract = "OBJECTIVES: This study aimed to determine the prevalence, risk factors of delirium and current practice of delirium management in intensive care units of various levels of care.RESEARCH METHODOLOGY/DESIGN: Prospective multicentre cohort study.SETTING: In all adult patients admitted to one of the participating intensive care units on World Delirium Awareness Day 2018, delirium point and period prevalence rates were measured between ICU admission and seven days after the index day.RESULTS: In total, 28 (33%) Dutch intensive care units participated in this study. Point-prevalence was 23% (range 41), and period-prevalence was 42% (range 70). University intensive care units had a significantly higher delirium point-prevalence compared with non-university units (26% vs.15%, p = 0.02). No significant difference were found in period prevalence (50% vs. 39%, p = 0.09). Precipitating risk factors, infection and mechanical ventilation differed significantly between delirium and non-delirium patients. No differences were observed for predisposing risk factors. A delirium protocol was present in 89% of the ICUs. Mean delirium assessment compliance measured was 84% (±19) in 14 units and estimated 59% (±29) in the other 14.CONCLUSION: Delirium prevalence in Dutch intensive care units is substantial and occurs with a large variation, with the highest prevalence in university units. Precipitating risk factors were more frequent in patients with delirium. In the majority of units a delirium management protocol is in place.",

keywords = "Adult, Cohort Studies, Critical Care, Critical Care Nursing, Delirium, Humans, Intensive Care Units, Netherlands, Prevalence, Prospective Studies, Risk Factors",

author = "Elke Berger and Evert-Jan Wils and Piet Vos and {van Santen}, Susanne and Jeroen Koets and Slooter, {Arjen J C} and {van der Woude}, Meta and Matty Koopmans and Rinket, {Martin A} and Oscar Hoiting and Hoogendoorn, {Emma E} and Streefkerk, {J{\"o}rn O} and {de Vreede}, {Els W} and Bea Riekerk and Simons, {Koen S} and Eryk Toscano and Schoonderbeek, {F Jeannette} and Hofstra, {Lieuwe S} and {van den Oever}, {Huub L A} and Raben, {Adrienne M T J} and Susanne Holman and Fleur Nooteboom and Carina Bethlehem and {Ten Cate}, Julia and Martijn Verkade and Lisa Mijzen and {de Man-van Ginkel}, {Janneke M} and Hester Vermeulen and {van den Boogaard}, Mark",

year = "2020",

month = dec,

doi = "10.1016/j.iccn.2020.102925",

language = "English",

volume = "61",

journal = "Intensive and Critical Care Nursing",

issn = "0964-3397",

publisher = "Churchill Livingstone",

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Berger, E, Wils, E-J, Vos, P, van Santen, S, Koets, J, Slooter, AJC, van der Woude, M, Koopmans, M, Rinket, MA, Hoiting, O, Hoogendoorn, EE, Streefkerk, JO, de Vreede, EW, Riekerk, B, Simons, KS, Toscano, E, Schoonderbeek, FJ, Hofstra, LS, van den Oever, HLA, Raben, AMTJ, Holman, S, Nooteboom, F, Bethlehem, C, Ten Cate, J, Verkade, M, Mijzen, L, de Man-van Ginkel, JM, Vermeulen, H & van den Boogaard, M 2020, 'Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study', Intensive & Critical Care Nursing, vol. 61, 102925. https://doi.org/10.1016/j.iccn.2020.102925

Prevalence and management of delirium in intensive care units in the Netherlands : An observational multicentre study. / Berger, Elke; Wils, Evert-Jan; Vos, Piet; van Santen, Susanne; Koets, Jeroen; Slooter, Arjen J C; van der Woude, Meta; Koopmans, Matty; Rinket, Martin A; Hoiting, Oscar; Hoogendoorn, Emma E; Streefkerk, Jörn O; de Vreede, Els W; Riekerk, Bea; Simons, Koen S; Toscano, Eryk; Schoonderbeek, F Jeannette; Hofstra, Lieuwe S; van den Oever, Huub L A; Raben, Adrienne M T J; Holman, Susanne; Nooteboom, Fleur; Bethlehem, Carina; Ten Cate, Julia; Verkade, Martijn; Mijzen, Lisa; de Man-van Ginkel, Janneke M; Vermeulen, Hester; van den Boogaard, Mark.

In: Intensive & Critical Care Nursing, Vol. 61, 102925, 12.2020.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prevalence and management of delirium in intensive care units in the Netherlands

T2 - An observational multicentre study

AU - Berger, Elke

AU - Wils, Evert-Jan

AU - Vos, Piet

AU - van Santen, Susanne

AU - Koets, Jeroen

AU - Slooter, Arjen J C

AU - van der Woude, Meta

AU - Koopmans, Matty

AU - Rinket, Martin A

AU - Hoiting, Oscar

AU - Hoogendoorn, Emma E

AU - Streefkerk, Jörn O

AU - de Vreede, Els W

AU - Riekerk, Bea

AU - Simons, Koen S

AU - Toscano, Eryk

AU - Schoonderbeek, F Jeannette

AU - Hofstra, Lieuwe S

AU - van den Oever, Huub L A

AU - Raben, Adrienne M T J

AU - Holman, Susanne

AU - Nooteboom, Fleur

AU - Bethlehem, Carina

AU - Ten Cate, Julia

AU - Verkade, Martijn

AU - Mijzen, Lisa

AU - de Man-van Ginkel, Janneke M

AU - Vermeulen, Hester

AU - van den Boogaard, Mark

PY - 2020/12

Y1 - 2020/12

N2 - OBJECTIVES: This study aimed to determine the prevalence, risk factors of delirium and current practice of delirium management in intensive care units of various levels of care.RESEARCH METHODOLOGY/DESIGN: Prospective multicentre cohort study.SETTING: In all adult patients admitted to one of the participating intensive care units on World Delirium Awareness Day 2018, delirium point and period prevalence rates were measured between ICU admission and seven days after the index day.RESULTS: In total, 28 (33%) Dutch intensive care units participated in this study. Point-prevalence was 23% (range 41), and period-prevalence was 42% (range 70). University intensive care units had a significantly higher delirium point-prevalence compared with non-university units (26% vs.15%, p = 0.02). No significant difference were found in period prevalence (50% vs. 39%, p = 0.09). Precipitating risk factors, infection and mechanical ventilation differed significantly between delirium and non-delirium patients. No differences were observed for predisposing risk factors. A delirium protocol was present in 89% of the ICUs. Mean delirium assessment compliance measured was 84% (±19) in 14 units and estimated 59% (±29) in the other 14.CONCLUSION: Delirium prevalence in Dutch intensive care units is substantial and occurs with a large variation, with the highest prevalence in university units. Precipitating risk factors were more frequent in patients with delirium. In the majority of units a delirium management protocol is in place.

AB - OBJECTIVES: This study aimed to determine the prevalence, risk factors of delirium and current practice of delirium management in intensive care units of various levels of care.RESEARCH METHODOLOGY/DESIGN: Prospective multicentre cohort study.SETTING: In all adult patients admitted to one of the participating intensive care units on World Delirium Awareness Day 2018, delirium point and period prevalence rates were measured between ICU admission and seven days after the index day.RESULTS: In total, 28 (33%) Dutch intensive care units participated in this study. Point-prevalence was 23% (range 41), and period-prevalence was 42% (range 70). University intensive care units had a significantly higher delirium point-prevalence compared with non-university units (26% vs.15%, p = 0.02). No significant difference were found in period prevalence (50% vs. 39%, p = 0.09). Precipitating risk factors, infection and mechanical ventilation differed significantly between delirium and non-delirium patients. No differences were observed for predisposing risk factors. A delirium protocol was present in 89% of the ICUs. Mean delirium assessment compliance measured was 84% (±19) in 14 units and estimated 59% (±29) in the other 14.CONCLUSION: Delirium prevalence in Dutch intensive care units is substantial and occurs with a large variation, with the highest prevalence in university units. Precipitating risk factors were more frequent in patients with delirium. In the majority of units a delirium management protocol is in place.

KW - Adult

KW - Cohort Studies

KW - Critical Care

KW - Critical Care Nursing

KW - Delirium

KW - Humans

KW - Intensive Care Units

KW - Netherlands

KW - Prevalence

KW - Prospective Studies

KW - Risk Factors

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U2 - 10.1016/j.iccn.2020.102925

DO - 10.1016/j.iccn.2020.102925

M3 - Article

C2 - 32868188

VL - 61

JO - Intensive and Critical Care Nursing

JF - Intensive and Critical Care Nursing

SN - 0964-3397

M1 - 102925

ER -

Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study

Abstract

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Keywords

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