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.

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.