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Relationship Between African-American Race and Delirium in the ICU.

ABSTRACT: OBJECTIVES:Delirium is a highly prevalent syndrome of acute brain dysfunction among critically ill patients that has been linked to multiple risk factors, such as age, preexisting cognitive impairment, and use of sedatives; but to date, the relationship between race and delirium is unclear. We conducted this study to identify whether African-American race is a risk factor for developing ICU delirium. DESIGN:A prospective cohort study. SETTING:Medical and surgical ICUs of a university-affiliated, safety net hospital in Indianapolis, IN. PATIENTS:A total of 2,087 consecutive admissions with 1,008 African Americans admitted to the ICU services from May 2009 to August 2012. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Incident delirium was defined as first positive Confusion Assessment Method for the ICU result after an initial negative Confusion Assessment Method for the ICU; and prevalent delirium was defined as positive Confusion Assessment Method for the ICU on first Confusion Assessment Method for the ICU assessment. The overall incident delirium rate in African Americans was 8.7% compared with 10.4% in Caucasians (p = 0.26). The prevalent delirium rate was 14% in both African Americans and Caucasians (p = 0.95). Significant age and race interactions were detected for incident delirium (p = 0.02) but not for prevalent delirium (p = 0.3). The hazard ratio for incident delirium for African Americans in the 18-49 years age group compared with Caucasians of similar age was 0.4 (0.1-0.9). The hazard and odds ratios for incident and prevalent delirium in other groups were not different. CONCLUSIONS:African-American race does not confer any additional risk for developing incident or prevalent delirium in the ICU. Instead, younger African Americans tend to have lower rates of incident delirium compared with Caucasians of similar age.

SUBMITTER: Khan BA

PROVIDER: S-EPMC5240583 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Relationship Between African-American Race and Delirium in the ICU.

Khan Babar A BA Perkins Anthony A Hui Siu L SL Gao Sujuan S Campbell Noll L NL Farber Mark O MO Boustani Malaz A MA

Critical care medicine 20160901 9

<h4>Objectives</h4>Delirium is a highly prevalent syndrome of acute brain dysfunction among critically ill patients that has been linked to multiple risk factors, such as age, preexisting cognitive impairment, and use of sedatives; but to date, the relationship between race and delirium is unclear. We conducted this study to identify whether African-American race is a risk factor for developing ICU delirium.<h4>Design</h4>A prospective cohort study.<h4>Setting</h4>Medical and surgical ICUs of a ...[more]

PMID: 27276344

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Project description:Prior research shows between-race differences in women's knowledge and emotions related to having dense breasts, thus suggesting that between-race differences in behavioral decision-making following receipt of breast density (BD) notifications are likely. Guided by the theory of planned behavior, this study examined differences in emotion-related responses (i.e., anxiety, worry, confusion) and behavioral cognition (e.g., intentions, behavioral attitudes) following receipt of BD notifications among African American (AA) and European American (EA) women. This study also examined whether race-related perceptions (i.e., discrimination, group-based medical mistrust), relevant knowledge and socioeconomic status (SES) explained the between race differences.Michigan women (N = 457) who presented for routine screening mammogram and had dense breasts, no prior breast cancer diagnoses, and had screen-negative mammograms were recruited from July, 2015 to March 2016. MANOVA was used to examine between race differences in psychological responses (i.e., emotional responses and behavioral cognition), and a multi-group structural regression model was used to examine whether race-related constructs, knowledge and SES mediated the effect of race on emotional responses and behavioral cognition. Prior awareness of BD was accounted for in all analyses.AA women generally reported more negative psychological responses to receiving BD notifications regardless of prior BD awareness. AA women had more favorable perceptions related to talking to their physicians about the BD notifications. Generally, race-related perceptions, SES, and related knowledge partially accounted for the effect of race on psychological response. Race-related perceptions and SES partially accounted for the differences in behavioral intentions. Between-race differences in emotional responses to BD notifications did not explain differences in women's intentions to discuss BD notifications with their physicians.Future examinations are warranted to examine whether there are between-race differences in actual post-BD notification behaviors and whether similar race-related variables account for differences.

Dataset Information

Relationship Between African-American Race and Delirium in the ICU.

Publications

Relationship Between African-American Race and Delirium in the ICU.

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