Melissa Noble, BCCCP, PharmD
University of South Florida College of Pharmacy
Tampa, Florida
Disclosure information not submitted.
Jemma Cropanese
Student
University of South Florida College of Pharmacy, United States
Disclosure information not submitted.
Title: Evaluation of ICU Delirium in English Speaking versus Non-English Speaking Patients
Introduction: Delirium is commonly encountered in ICU patients and can lead to short- and long-term cognitive impairments and a longer hospital length of stay. Language differences can cause communication-related medical errors and increased psychological stress compared to patients that speak the same language as the healthcare providers. The purpose of this study is to compare the incidence and management of delirium in English speaking versus non-English speaking patients in the ICU. It is hypothesized that non-English speaking patients will have a higher prevalence of delirium.
Methods: A single-center, retrospective review was conducted of randomly selected adult patients who were admitted to the ICU for at least 48 hours from July 2018 to December 2018 and had a preferred language documented in the medical record. Patients were excluded if they had a pre-existing neurologic or psychiatric disorder, history of alcohol or substance abuse or if delirium could not be assessed due to deep levels of sedation (RASS -4 or -5). Delirium was evaluated using the Intensive Care Delirium Screening Checklist (ICDSC).
Results: A total of 100 patients were included in the analysis, 50 in the English speaking group and 50 in the non-English speaking group. Baseline characteristics, including age, gender and admitting diagnosis, were similar between groups. Additionally, there was no difference in factors that could lead to an increased risk of delirium, such as mechanical ventilation (24% vs 22%, p=0.81) and benzodiazepine use (38% vs 40%, p=0.84). The incidence of delirium (20% vs 34%, p=0.12) and average ICDSC scores (0.63 vs 0.86, p=0.24) were not statistically significantly different between groups. There also was no difference in the use of antipsychotic medications for delirium management (6% vs 8%, p=1.0). ICU length of stay was similar between groups (98.6 vs 106.7 hours, p=0.50).
Conclusions: The results of this study suggest that the prevalence of delirium is similar in ICU patients regardless of the patient’s primary language. There also does not appear to be any difference in the management of delirium based on the language spoken. However, larger, prospective studies are needed to confirm these results.