Delirium and Its Motoric Subtypes: A Study of 614 Critically Ill Patients
2006/01/27 by Josh F. Peterson, Brenda T. Pun, Robert S. Dittus +5 · 667 citations
Medicine · #Anesthesia #Anesthesia and Sedative Agents #Cohort #Cohort study #Confidence interval #Delirium #Emergency medicine #Intensive Care Unit Cognitive Disorders #Intensive care #Intensive care medicine #Intensive care unit #Internal medicine #Mechanical ventilation #Medicine #Odds ratio #Organic mental disorders #Pediatrics #Prospective cohort study #Sedation #Thermal Regulation in Medicine
paper · doi:10.1111/j.1532-5415.2005.00621.x
published in Journal of the American Geriatrics Society 54(3), 479-484 (Wiley)
openalex publication_date 2006/01/27 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Abstract
OBJECTIVES: To describe the motoric subtypes of delirium in critically ill patients and compare patients aged 65 and older with a younger cohort. DESIGN: Prospective cohort study. SETTING: The medical intensive care unit (MICU) of a tertiary care academic medical center. PARTICIPANTS: Six hundred fourteen MICU patients admitted during a process improvement initiative to monitor levels of sedation and delirium. MEASUREMENTS: MICU nursing staff assessed delirium and level of consciousness in all MICU patients at least once per 12-hour shift using the Confusion Assessment Method for the Intensive Care Unit and the Richmond Agitation-Sedation Scale. Delirium episodes were categorized as hypoactive, hyperactive, and mixed type. RESULTS: Delirium was detected in 112 of 156 (71.8%) subjects aged 65 and older and 263 of 458 (57.4%) subjects younger than 65. Mixed type was most common (54.9%), followed by hypoactive delirium (43.5%) and purely hyperactive delirium (1.6%). Patients aged 65 and older experienced hypoactive delirium at a greater rate than younger patients (41.0% vs 21.6%, P<.001) and never experienced hyperactive delirium. Older age was strongly and independently associated with hypoactive delirium (adjusted odds ratio=3.0, 95% confidence interval=1.7-5.3), compared with no delirium in a model that adjusted for other important determinants of delirium including severity of illness, sedative medication use, and ventilation status. CONCLUSION: Older age is a strong predictor of hypoactive delirium in MICU patients, and this motoric subtype of delirium may be missed in the absence of active monitoring.
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