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Nutrients 2018, 10(11), 1712;

Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan
Department of Health and Nutrition, Faculty of Human Sciences, Tokiwa University, 1-430-1, Miwa Mito, Ibaraki 310-5385, Japan
Author to whom correspondence should be addressed.
Received: 16 October 2018 / Revised: 4 November 2018 / Accepted: 6 November 2018 / Published: 8 November 2018
(This article belongs to the Special Issue Nutrients for Cardiometabolic Health and Brain Function)
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Background: Delirium is a common occurrence in patients admitted to the intensive care unit and is related to mortality and morbidity. Malnutrition is a predisposing factor for the development of delirium. Nevertheless, whether the nutritional status on admission anticipates the development of delirium in patients with acute cardiovascular diseases remains unknown. Objective: This study aims to assess the correlation between the nutritional status on admission using the nutritional index and the development of delirium in the coronary intensive care unit. Design: We examined 653 consecutive patients (mean age: 70 ± 14 years) admitted to the coronary intensive care unit of Juntendo University Hospital between January 2015 and December 2016. We evaluated three nutritional indices frequently used to assess the nutritional status, i.e., Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT). We defined delirium as patients with a delirium score >4 using the Intensive Care Delirium Screening Checklist. Results: Delirium was present in 58 patients. All nutritional indices exhibited a tendency for malnutrition in the delirium group compared with the non-delirium group (GNRI, 86.5 ± 9.38 versus 91.6 ± 9.89; PNI, 36.4 ± 6.95 versus 41.6 ± 7.62; CONUT, 5.88 ± 3.00 versus 3.61 ± 2.56; for all, p < 0.001). Furthermore, the maximum delirium score increased progressively from the low- to the high-risk group, as evaluated by each nutritional index (GNRI, PNI, CONUT; for all, p < 0.001). A multivariate analysis revealed that the PNI and CONUT were independent risk factors for the occurrence of delirium. Conclusions: A marked correlation exists between the nutritional index on admission, especially PNI and CONUT, and the development of delirium in patients with acute cardiovascular diseases, suggesting that malnutrition assessment upon admission could help identify patients at high risk of developing delirium. View Full-Text
Keywords: delirium; malnutrition; acute cardiovascular disease; coronary care unit delirium; malnutrition; acute cardiovascular disease; coronary care unit

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Sugita, Y.; Miyazaki, T.; Shimada, K.; Shimizu, M.; Kunimoto, M.; Ouchi, S.; Aikawa, T.; Kadoguchi, T.; Kawaguchi, Y.; Shiozawa, T.; Takasu, K.; Hiki, M.; Takahashi, S.; Sumiyoshi, K.; Iwata, H.; Daida, H. Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium. Nutrients 2018, 10, 1712.

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