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Acute kidney injury as a risk factor of hyperactive delirium: A case control study

Research output: Contribution to journalArticle

R. Y.Y. Wan, C. A. McKenzie, D. Taylor, L. Camporota, M. Ostermann

Original languageEnglish
Pages (from-to)194-197
Number of pages4
JournalJournal of Critical Care
Publication statusPublished - 1 Feb 2020

King's Authors


Purpose: Delirium and acute kidney injury (AKI) are common organ dysfunctions during critical illness. Both conditions are associated with serious short- and long-term complications. We investigated whether AKI is a risk factor for hyperactive delirium. Methods: This was a single-centre case control study conducted in a 30 bedded mixed Intensive Care Unit in the UK. Hyperactive delirium cases were identified by antipsychotic initiation and confirmation of delirium diagnosis through validated chart review. Cases were compared with non-delirium controls matched by Acute Physiology and Chronic Health Evaluation II score and gender. AKI was defined by the KDIGO criteria. Results: 142 cases and 142 matched controls were identified. AKI stage 3 was independently associated with hyperactive delirium [Odds ratio (OR) 5.40 (95% confidence interval (CI) 2.33–12.51]. Other independent risk factors were mechanical ventilation [OR 2.70 (95% CI 1.40–5.21)], alcohol use disorder [OR 5.80 (95% CI 1.90–17.72)], and dementia [OR 9.76 (95% CI 1.09–87.56)]. Hospital length of stay was significantly longer in delirium cases (29 versus 20 days; p = .004) but hospital mortality was not different. Conclusions: AKI stage 3 is independently associated with hyperactive delirium. Further research is required to explore the factors that contribute to this association.

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