Associations of albumin and nutritional index factors with delirium in patients admitted to the cardiac intensive care unit

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Soo Jin Na¹  Chi-Min Park¹  Chi Ryang Chung¹  Ryoung Eun Ko¹  Tae Wan Kim¹  Jeong Hoon Yang²  Ki Hong Choi³ 

[1] Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;

关键词: delirium;    albumin;    malnutrition;    cardiac intensive care unit;    nutrition indexes;   

DOI  :  10.3389/fcvm.2023.1100160

 received in 2022-11-16, accepted in 2023-02-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundLimited data are available on the association of malnutrition with the occurrence of delirium in the cardiac intensive care unit (CICU). Thus, we aimed to analyze whether nutritional indices and their components can predict the development of delirium in CICU.MethodsWe enrolled 2,783 patients admitted to the CICU of Samsung Medical Center for more than 24 h between September 2012 and December 2018. We assessed the nutritional status at admission using three indices, the Prognostic Nutrition Index (PNI), the Geriatric Nutritional Risk Index (GNRI), and the Controlling Nutritional Status (CONUT). Then, we compared predictive performances for the occurrence of delirium among nutritional indices using Delong’s test.ResultsDelirium developed in 678 patients (24.3%) assessed three times daily for 7 days of CICU stay. Nutritional indices had fair predictive performance for development of delirium in critically ill cardiac patients using the area under the receiver-operating characteristic curve (AUROC: 0.729 for the GNRI, 0.728 for PNI, and 0.762 for CONUT). Furthermore, the AUROC of albumin alone (0.77, 95% CI, 0.75–0.79) was significantly greater than that of either GNRI (p < 0.001) or PNI (p < 0.001). In a multivariable analysis including each component of nutritional indices, albumin was a significant predictor for delirium but not absolute lymphocyte count, bodyweight/ideal bodyweight, or total cholesterol level as a component of nutritional indices.ConclusionPredictive performances of nutritional indices for the occurrence of delirium were acceptable in patients admitted to CICU. Albumin alone might be a helpful and straightforward indicator for the occurrence of delirium.

【 授权许可】

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Copyright © 2023 Kim, Ko, Na, Chung, Choi, Park and Yang.