Pogostost delirija pri cepljenih in necepljenih bolnikih proti SARS-CoV-2 na enoti intenzivne terapije Klinike za infekcijske bolezni in vročinska stanja: retrospektivna analiza : magistrsko delo

Tokmaković, Adisa (author), Mlinar, Suzana (mentor), Perme Hajdinjak, Janja (comentor), Zore, Anamarija (reviewer)

Uvod: Delirij ali akutna zmedenost velja za enega najpogostejših sindromov v enotah intenzivne terapije in je pogosto posledica okužbe dihal. Je nevrovedenjska motnja, ki je premalo diagnosticirana in zato premalo zdravljena, vendar potencialno reverzibilna in je lahko preprečimo. Delirij pri hospitaliziranih bolnikih s covidom-19 je pokazatelj povečane umrljivosti in podaljšane hospitalizacije. Namen: Namen magistrskega dela je raziskati pojavnost delirija na enoti intenzivne terapije Klinike za infekcijske bolezni in vročinska stanja Ljubljana pri bolnikih s covidom-19, ki so bili cepljeni in tistimi, ki niso bili cepljeni. Metode dela: Izvedli smo neintervencijsko, retrospektivno raziskavo v katero smo vključili bolnike s covidom-19, ki so bili sprejeti na intenzivno enoto Klinike za infekcijske bolezni in vročinska stanja Ljubljana med januarjem 2020 in decembrom 2023. Rezultati: V raziskavo je bilo vključenih 170 bolnikov s covidom-19, 68,8 % je bilo moških in 31,2 % žensk. Delirij se je pogosteje pojavljal (92,1%) med necepljenimi bolniki proti SARS-CoV-2, manj pri cepljenih (73,1%). Kullbackov 2Î test kaže statistično pomembne razlik v pojavnosti delirija pri bolnikih s covidom-19, ki niso cepljeni (p = 0,005), ter v pojavnosti delirija pri necepljenih moških bolnikih s covidom-19 v primerjavi s cepljenimi moškimi bolniki (p=0,013). Razprava in zaključek: Delirij je pogostejši pri necepljenih bolnikih s covidom-19, kar je skladno z raziskavo uporabljeno v tej študiji. Cepljenje ni vplivalo na dolžino hospitalizacije ali potrebo po fizičnih ovirnicah, kar nakazuje vpliv drugih dejavnikov, kot so splošno zdravstveno stanje in resnost poteka bolezni covid-19. Prepoznana je bila potreba po sistematičnem pristopu k ocenjevanju delirija v vsaki izmeni z validiranimi orodji, kot sta CAM-ICU in ICDSC, ki omogočata zgodnje prepoznavanje in boljše obvladovanje delirija v klinični praksi.

• Language: Slovenian
• Keywords: magistrska dela, zdravstvena nega, covid-19, cepljenje, delirij, oviranje
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Tokmaković]
• Year: 2025
• Number of pages: 50 str., [4] str. pril.
• PID: 20.500.12556/RUL-169578
• UDC: 616-083
• COBISS.SI-ID: 238360323
• Publication date in RUL: 05.06.2025

Secondary language

• Language: English
• Title: The frequency of delirium in vaccinated and unvaccinated patients against SARS-CoV-2 in the intensive care unit of the Clinic for Infectious Diseases and Febrile Conditions: a retrospective analysis : master thesis

Abstract

Introduction: Delirium or acute confusional state is considered one of the most common syndromes in intensive care units (ICUs); it is a neurobehavioral disorder that is underdiagnosed and therefore undertreated, but potentially reversible and preventable. Delirium in hospitalized patients with COVID-19 is an indicator of increased mortality and prolonged hospitalization. Purpose: The purpose of the master's thesis is to investigate the incidence of delirium in the ICU unit of the Clinic for Infectious Diseases and Fevers Ljubljana (KIBVS) in vaccinated and unvaccinated COVID-19 patients. Methods: We conducted a non-interventional, retrospective study in which we included COVID-19 positive patients admitted to KIBVS Ljubljana between January 2020 and December 2023. Results: The study included 170 patients with COVID-19, 68.8% were male and 31.2% female. Delirium was more common (92.1%) among unvaccinated patients against SARS-CoV-2, and less common among vaccinated patients (73.1%). Kullback's 2Î test shows statistically significant differences in the incidence of delirium in unvaccinated COVID-19 patients (p = 0.005), and in the incidence of delirium in unvaccinated male COVID-19 patients compared to vaccinated male patients (p = 0.013). Discussion and conclusion: Delirium is more common in unvaccinated COVID-19 patients, which is consistent with the research used in this study. Vaccination did not affect the length of hospital stay or the need for physical restraints, suggesting the influence of other factors such as general health status and severity of COVID-19 disease. The need for a systematic approach to assessing delirium in each shift using validated tools such as CAM-ICU and ICDSC was recognized, allowing for early recognition and better management of delirium in clinical practice.

• Keywords: master's theses, nursing care, COVID-19, vaccination, delirium, restraint