Background and Objectives: We analyzed
delirium testing,
delirium prevalence,
critical care associations outcomes at the time of hospital discharge in patients with
acute brain injury (ABI) due to
acute ischemic stroke (AIS), non-
traumatic subarachnoid hemorrhage (SAH), non-traumatic intraparenchymal
hemorrhage (IPH), and
traumatic brain injury (TBI) admitted to an intensive care unit. Materials and Methods: We examined the frequency of assessment for
delirium using the
Confusion Assessment Method for the intensive care unit. We assessed
delirium testing frequency, associated factors, positive test outcomes, and their correlations with clinical care, including nonpharmacological interventions and
pain, agitation, and distress management. Results: Amongst 11,322 patients with ABI,
delirium was tested in 8220 (726%). Compared to patients 18-44 years of age, patients 65-79 years (aOR 0.79 [0.69, 0.90]), and those 80 years and older (aOR 0.58 [0.50, 0.68]) were less likely to undergo
delirium testing. Compared to English-speaking patients, non-English-speaking patients (aOR 0.73 [0.64, 0.84]) were less likely to undergo
delirium testing. Amongst 8220, 2217 (27.2%) tested positive for
delirium. For every day in the ICU, the odds of testing positive for
delirium increased by 1.11 [0.10, 0.12].
Delirium was highest in those 80 years and older (aOR 3.18 [2.59, 3.90]).
Delirium was associated with
critical care resource utilization and with significant odds of mortality (aOR 7.26 [6.07, 8.70] at the time of hospital discharge. Conclusions: In conclusion, we find that seven out of ten patients in the neurocritical care unit are tested for
delirium, and approximately two out of every five patients test positive for
delirium. We demonstrate disparities in
delirium testing by age and preferred language, identified high-risk subgroups, and the association between
delirium,
critical care resource use, complications, discharge GCS, and disposition. Prioritizing equitable testing and diagnosis, especially for elderly and non-English-speaking patients, is crucial for delivering quality care to this vulnerable group.