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Delirium Among Pediatric Patients Admitted to Open-Heart Surgery Intensive Care Unit: A Cross-Sectional Study Investigating a Common Challenge and Concern, and Its Inciting Factors Publisher



Mirzaaghayan M1 ; Memarian S1 ; Abdshah A2 ; Ghavami M3 ; Roozbahani G4 ; Naseri F5 ; Jolani MS2 ; Ghahvechi M1 ; Gharib B1
Authors
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Authors Affiliations
  1. 1. Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Cardiovascular Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. School of Nursing, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Source: Current Journal of Neurology Published:2024


Abstract

Background: Delirium is a common challenge in pediatric open heart surgery intensive care units (OH-ICU). It is believed that emergence of delirium can lead to extended hospitalization periods. Therefore, we decided to investigate the association between delirium and its inciting factors in OH-ICU. Methods: This was a cross-sectional study on 92 pediatric patients admitted to OH-ICU of “Children’s Medical Center” in Tehran, Iran, for more than 48 hours. To screen for delirium, the Cornell Assessment of Pediatric Delirium (CAPD ≥ 9) was utilized. Demographics, length of stay, development of complications, delirium, and factors associated with delirium were recorded. Results: We observed 34 (37%) cases of delirium in patients in OH-ICU. We had 51% male patients and 49% female ones, with a median age of 8 (0.2-144) months. The median length of mechanical ventilation was 11.5 hours (2-405) and they stayed in the hospital for a median of 4 days (2-31). The most common cardiac abnormality was ventricular septal defect (18%), associated with tetralogy of Fallot (TOF) (10%). Most of the patients (71%) experienced no adverse events during their stay; however, among those who did, vomiting and post-operation chorea were the most prevalent. Among the patients in our study, age [adjusted odds ratio (AOR) = 0.91], weight (AOR = 1.34), and sex (AOR = 0.31 for boys vs. girls) were significantly associated with delirium. Conclusion: We observed delirium in 37% of the patients. Development of delirium in patients admitted to pediatric intensive care unit (PICU) was associated with younger age, female sex, and higher weight. © 2024 Iranian Neurological Association, and Tehran University of Medical Sciences Published by Tehran University of Medical Sciences.