Don't call me crazy! Delirium occurs outside of the ICU.

Introduction: Delirium has been well studied among patients in the Intensive Care Unit (ICU); however, data beyond the ICU is limited. The purpose of this study is to prospectively evaluate the incidence and associated risk factors for delirium in non-critical care areas (NCCA). Methods: After IRB approval, a prospective cohort study was conducted at our urban Level I Trauma Center from December 2015 to February 2016. All patients admitted to the designated study area by a trauma surgeon were included. The Confusion Assessment Method (CAM) was administered every 12 hours until discharge. Delirious patients (CAM+) were administered the CAM-S to quantify the severity of delirium. Demographics, laboratory data, and inpatient medication lists were analyzed. Results: Of 148 participants, 12 (8%) were CAM+ and 136 (92%) were CAM-. The average CAM-S of CAM+ patients was 7 +/- 3. Included patients were 52 +/- 20 years old and 45% male. Of patients >=65 years old, 9 (21%) were CAM+. Medications associated with delirium were: Albuterol (p=0.01), Atorvastatin (p=0.01), Duloxetine (p=0.04), Sertraline (p=0.04), Folic Acid (p=0.01), Thiamine (p=0.01), Vitamin D (p= 65 years old. Many risk factors identified among NCCA patients are consistent with the ICU literature; however, our CAM+ patients had additional risk factors which have not been previously associated with the development of delirium. Screening of NCCA patients for delirium should be considered. Study type and Level of Evidence Prognostic and Epidemological and Level IV (C) 2017 Lippincott Williams & Wilkins, Inc.

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