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Pediatric Delirium and Associated Risk Factors

A Single-Center Prospective Observational Study*

Silver, Gabrielle MD1; Traube, Chani MD2; Gerber, Linda M. PhD3; Sun, Xuming MS3; Kearney, Julia MD4; Patel, Anita MD5; Greenwald, Bruce MD2

Pediatric Critical Care Medicine: May 2015 - Volume 16 - Issue 4 - p 303–309
doi: 10.1097/PCC.0000000000000356
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Objective: To describe a single-institution pilot study regarding prevalence and risk factors for delirium in critically ill children.

Design: A prospective observational study, with secondary analysis of data collected during the validation of a pediatric delirium screening tool, the Cornell Assessment of Pediatric Delirium.

Setting: This study took place in the PICU at an urban academic medical center.

Patients: Ninety-nine consecutive patients, ages newborn to 21 years.

Intervention: Subjects underwent a psychiatric evaluation for delirium based on the Diagnostic and Statistical Manual IV criteria.

Measurements and Main Results: Prevalence of delirium in this sample was 21%. In multivariate analysis, risk factors associated with the diagnosis of delirium were presence of developmental delay, need for mechanical ventilation, and age 2–5 years.

Conclusions: In our institution, pediatric delirium is a prevalent problem, with identifiable risk factors. Further large-scale prospective studies are required to explore multi-institutional prevalence, modifiable risk factors, therapeutic interventions, and effect on long-term outcomes.

1Department of Child Psychiatry, Weill Medical College, New York, NY.

2Pediatric Critical Care Medicine, Weill Cornell Medical College, New York, NY.

3Department of Public Health, Weill Cornell Medical College, New York, NY.

4Department of Pediatrics and Psychiatry, Memorial Sloan-Kettering Cancer Center, New York, NY.

5Department of Pediatrics, NY Presbyterian Hospital, New York, NY.

*See also p. 375.

This study was performed at Weill Cornell Medical College/NY Presbyterian Hospital.

Drs. Silver and Traube contributed equally to this study.

Drs. Traube and Greenwald received support for travel from Weill Cornell Medical College. Dr. Greenwald received support for travel from the Society of Critical Care Medicine. Dr. Greenwald consults for various law firms. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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©2015The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies