| dc.rights.license | CC-BY-NC-ND | |
| dc.contributor | J. van der Aa, A. Slooter | |
| dc.contributor.advisor | Slooter, Arjen | |
| dc.contributor.author | Reinartz, Cas | |
| dc.date.accessioned | 2025-06-29T23:02:10Z | |
| dc.date.available | 2025-06-29T23:02:10Z | |
| dc.date.issued | 2025 | |
| dc.identifier.uri | https://studenttheses.uu.nl/handle/20.500.12932/49083 | |
| dc.description.abstract | Introduction
Delirium is a common and serious complication in intensive care unit (ICU) patients, associated with neuropsychiatric morbidity and mortality. Traditionally, delirium subtyping was based on observable psychomotor symptoms, which may not fully capture underlying biological mechanisms, limiting targeted interventions. This retrospective cohort study investigated the relationship between clinically defined delirium subphenotypes, long-term cognitive outcomes and mortality in adult ICU patients.
Methods
Patients were categorized into six delirium subphenotypes based on clinical criteria: Respiratory, Circulatory, Pain, Infectious, Metabolic and Sedative. The duration of individual subphenotypes, allowing for co-occurrence, was analysed. 2289 ICU admissions (2007-2023) were analysed. Cognitive function was assessed using the Cognitive Failure Questionnaire-14 (CFQ-14) one year after discharge. Additionally, one-year mortality was determined.
Results
Delirium was highly prevalent (88.6%). Circulatory (73.7%) and respiratory (79.7%) subphenotypes were most common and frequently co-occurred. Multivariable linear regression showed no significant association between individual subphenotype duration and CFQ-14 at one-year follow-up. Similarly, logistic regression found no association between subphenotype duration and one-year mortality. However, time-dependent Cox regression showed that delirium duration increased the hazard of death over time (HR = 1.009 [95% CI: 1.002-1.016]).
Discussion
Our study found no differences in association between delirium subphenotypes and long-term cognitive impairment or mortality, potentially supporting a final common pathway for delirium. Discrepancies with previous studies may be explained by differences in follow-up response rates or the protective effect of delirium monitoring. Further research with objective measures or prospectively collected data is needed to investigate the role of delirium subphenotyping in patient care. | |
| dc.description.sponsorship | Utrecht University | |
| dc.language.iso | EN | |
| dc.subject | This retrospective study investigates if six clinical subphenotypes of delirium in adult ICU patients are associated with long-term cognitive decline and mortality. It analyzed the relationship between the duration of each subphenotype and one-year outcomes (CFQ-14 scores and mortality). The research found no significant association between any specific subphenotype and these outcomes , supporting the theory of a "final common pathway" for delirium. | |
| dc.title | Delirium Subphenotypes in the ICU:
Comparing Effects on Cognition and Mortality | |
| dc.type.content | Master Thesis | |
| dc.rights.accessrights | Open Access | |
| dc.subject.keywords | Delirium; Intensive Care Unit (ICU); Delirium Subphenotypes; Cognitive Impairment; Mortality; Retrospective Cohort Study; Final Common Pathway; CFQ-14: Clinical Phenotypes; Endotypes; Pathophysiology; Retrospective Cohort Study; Algorithm of Zaal; Cox Proportional Hazard Model; SOFA Score; Hazard Ratio (HR); Odds Ratio (OR); Prevalence; | |
| dc.subject.courseuu | Geneeskunde | |
| dc.thesis.id | 46834 | |
