Lin et al identified risk factors for early-onset delirium in a mechanically ventilated patient in the intensive care unit (ICU). These factors can help to identify a patient who may require closer monitoring and more aggressive management. The authors are from Chang Gung Memorial Hospital in Taipei, Taiwan.


Early-onset delirium was defined as onset within the first 5 days of the ICU stay (not necessarily the duration of mechanical ventilation)..


Independent risk factors:

(1) sepsis syndrome

(2) hypoalbuminemia



• The analytical method and lower limit of normal for serum albumin were not reported. Hypoalbuminemia may be a serum albumin below the lower limit of normal. The severity of hypoalbuminemia can be graded but this was not reported here.

• Sepsis was defined per the ACCP and SCCM consensus conference )Chest 1992; 101: 1481-1483). The presence and type of bacterial isolates are not reported.

• Exclusion criteria included neurologic disease, post-operative status and certain medications (high dose morphine, high dose midazolam, high dose sedation plus neuromuscular blockng agents) as listed on page 373.


Diabetes mellitus was significant in the univariate but not the multivariate analysis.


Patients who developed early-onset delirium:

(1) had longer hospital stays

(2) required a greater duration of mechanical ventilation

(3) had a higher rate of nosocomial infection

(4) higher in-hospital mortality


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