Delirium and Associated Length of Stay and Costs in Critically Ill Patients

Claudia Dziegielewski; Charlenn Skead; Toros Canturk; Colleen Webber; Shannon M Fernando; Laura H Thompson; Madison Foster; Vanja Ristovic; Peter G Lawlor; Dipayan Chaudhuri; Chintan Dave; Brent Herritt; Shirley H Bush; Salmaan Kanji; Peter Tanuseputro; Kednapa Thavorn; Erin Rosenberg; Kwadwo Kyeremanteng

doi:10.1155/2021/6612187

Delirium and Associated Length of Stay and Costs in Critically Ill Patients

Crit Care Res Pract. 2021 Apr 24:2021:6612187. doi: 10.1155/2021/6612187. eCollection 2021.

Authors

Claudia Dziegielewski¹, Charlenn Skead¹, Toros Canturk¹, Colleen Webber^{2

3

4}, Shannon M Fernando^{5

6}, Laura H Thompson², Madison Foster², Vanja Ristovic⁷, Peter G Lawlor^{2

3

8}, Dipayan Chaudhuri⁵, Chintan Dave¹, Brent Herritt⁵, Shirley H Bush^{2

3

8}, Salmaan Kanji^{2

9

10}, Peter Tanuseputro^{3

4

8

9}, Kednapa Thavorn^{4

9

11

12}, Erin Rosenberg⁵, Kwadwo Kyeremanteng^{5

8}

Affiliations

¹ Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
² Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
³ Bruyère Research Institute, Ottawa, ON, Canada.
⁴ ICES uOttawa, Ottawa, ON, Canada.
⁵ Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁶ Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
⁷ Department of Anesthesia, University of Ottawa, Ottawa, ON, Canada.
⁸ Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁹ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
¹⁰ Department of Pharmacy, Ottawa, ON, Canada.
¹¹ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹² The Ottawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Abstract

Purpose: Delirium frequently affects critically ill patients in the intensive care unit (ICU). The purpose of this study is to evaluate the impact of delirium on ICU and hospital length of stay (LOS) and perform a cost analysis.

Materials and methods: Prospective studies and randomized controlled trials of patients in the ICU with delirium published between January 1, 2015, and December 31, 2020, were evaluated. Outcome variables including ICU and hospital LOS were obtained, and ICU and hospital costs were derived from the respective LOS.

Results: Forty-one studies met inclusion criteria. The mean difference of ICU LOS between patients with and without delirium was significant at 4.77 days (p < 0.001); for hospital LOS, this was significant at 6.67 days (p < 0.001). Cost data were extractable for 27 studies in which both ICU and hospital LOS were available. The mean difference of ICU costs between patients with and without delirium was significant at $3,921 (p < 0.001); for hospital costs, the mean difference was $5,936 (p < 0.001).

Conclusion: ICU and hospital LOS and associated costs were significantly higher for patients with delirium, compared to those without delirium. Further research is necessary to elucidate other determinants of increased costs and cost-reducing strategies for critically ill patients with delirium. This can provide insight into the required resources for the prevention of delirium, which may contribute to decreasing healthcare expenditure while optimizing the quality of care.

Publication types

Review