Abstract
Introduction: This study explores the relationship between delirium, as assessed by the Confusion Assessment Method-ICU (CAM-ICU, and catatonia, assessed by the Bush Francis Catatonia Screening Instrument (BFCSI) [2], in cardiac care unit (CCU). Delirium has been shown to worsen clinical outcomes [4]. Catatonia, while less studied in ICU settings, is essential due to its potential overlap with delirium [1,3,5]. The preliminary analysis provides insights into the independent occurrence of delirium and catatonia and their impacts on clinical outcomes.
Methods: Consecutive adult patients (≥ 20 years) admitted to the CCU were enrolled. Delirium was screened daily using CAM-ICU until CCU discharge, while catatonia was assessed using the BFCSI. Clinical outcomes included CCU days and length of stay (LOS). Additional clinical variables included age, gender, BMI, Activities of Daily Living (ADL), Clinical Frailty Scale (CFS), APACHE II scores. Statistical significance was determined using P-values, with <0.05 considered significant.
Results: Our preliminary findings enrolled 26 participants. Delirium developed at 15.4% (4/26), and catatonia at 19.2% (5/26). Participants with delirium were frailer, had lower baselines BMI and ADL, and had higher 48h_APACHE II scores compared to those without delirium. Notably, participants with delirium had significantly longer median ICU days (19.0 days vs. 4.0 days) and LOS (31.0 days vs. 13.5 days) compared to the non-delirium group (p<0.05). Among the five participants with catatonia, no significant differences in clinical outcomes were observed. However, two of the four delirium participants also had catatonia, suggesting that focusing solely on delirium may overlook the presence of catatonia, which could potentially influence clinical outcomes.
Discussion: The preliminary results indicate that delirium is associated with worse ICU outcomes, including higher illness severity and prolonged length of stay. While catatonia may occur independently of delirium, but its impact remains inconclusive based on the current data. The presence of catatonia in patients without delirium (Catatonia [+] but CAM-ICU [-]) emphasizes the need for separate screening to avoid missed diagnoses. More extensive studies are required to clarify catatonia’s role in ICU outcomes and implications for ICU management. These findings suggest the need for comprehensive assessment strategies in CCU settings
Notes
References:
1. Appiani, F.J., Duarte, J.M., Sauré, M., Rodríguez, C.F., Momeño, V., Yaryour, C., & Sarotto, L. (2023). Catatonia and delirium assessment of comorbidity, prevalence, and therapeutic response in medically ill inpatients from a university hospital. Journal of Clinical Psychopharmacology, 43(1), 55-59.
2. Bush, G., Fink, M., Petrides, G., Dowling, F., & Francis, A. (1996). Catatonia. I. Rating scale and standardized examination. Acta Psychiatrica Scandinavica, 93(2), 129-136.
3. Connell, J., Kim, A., Brummel, N. E., Patel, M. B., Vandekar, S. N., Pandharipande, P., Dittus, R. S., Heckers, S., Ely, E. W., & Wilson, J. E. (2021). Advanced age is associated with catatonia in critical illness: Results from the delirium and catatonia prospective cohort investigation. Frontiers in Psychiatry, 12.
4. Dziegielewski, C., Skead, C., Canturk, T., Webber, C., & Fernando, S.M., …Chaudhuri, D. (2021). Delirium and associated length of stay and costs in critically ill patients. Critical Care Research and Practice,. https://doi.org/10.1155/2021/6612187
5. Tachibana, M., Ishizuka, K., & Inada, T. (2022). Catatonia and delirium: Similarity and overlap of acute brain dysfunction. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.876727
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Acute Care, Instrument and Tool development, Implementation Science
Recommended Citation
Li, Hsiu-Ching; Huang, Chi-Hung; Chiu, Wei-Che; Lin, Chia-Chi; and Pan, Zi-Jing, "Delirium and Catatonia in the CCU: Distinct Conditions Shaping Clinical Outcomes" (2025). International Nursing Research Congress (INRC). 58.
https://www.sigmarepository.org/inrc/2025/posters_2025/58
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Delirium and Catatonia in the CCU: Distinct Conditions Shaping Clinical Outcomes
Seattle, Washington, USA
Introduction: This study explores the relationship between delirium, as assessed by the Confusion Assessment Method-ICU (CAM-ICU, and catatonia, assessed by the Bush Francis Catatonia Screening Instrument (BFCSI) [2], in cardiac care unit (CCU). Delirium has been shown to worsen clinical outcomes [4]. Catatonia, while less studied in ICU settings, is essential due to its potential overlap with delirium [1,3,5]. The preliminary analysis provides insights into the independent occurrence of delirium and catatonia and their impacts on clinical outcomes.
Methods: Consecutive adult patients (≥ 20 years) admitted to the CCU were enrolled. Delirium was screened daily using CAM-ICU until CCU discharge, while catatonia was assessed using the BFCSI. Clinical outcomes included CCU days and length of stay (LOS). Additional clinical variables included age, gender, BMI, Activities of Daily Living (ADL), Clinical Frailty Scale (CFS), APACHE II scores. Statistical significance was determined using P-values, with <0.05 considered significant.
Results: Our preliminary findings enrolled 26 participants. Delirium developed at 15.4% (4/26), and catatonia at 19.2% (5/26). Participants with delirium were frailer, had lower baselines BMI and ADL, and had higher 48h_APACHE II scores compared to those without delirium. Notably, participants with delirium had significantly longer median ICU days (19.0 days vs. 4.0 days) and LOS (31.0 days vs. 13.5 days) compared to the non-delirium group (p<0.05). Among the five participants with catatonia, no significant differences in clinical outcomes were observed. However, two of the four delirium participants also had catatonia, suggesting that focusing solely on delirium may overlook the presence of catatonia, which could potentially influence clinical outcomes.
Discussion: The preliminary results indicate that delirium is associated with worse ICU outcomes, including higher illness severity and prolonged length of stay. While catatonia may occur independently of delirium, but its impact remains inconclusive based on the current data. The presence of catatonia in patients without delirium (Catatonia [+] but CAM-ICU [-]) emphasizes the need for separate screening to avoid missed diagnoses. More extensive studies are required to clarify catatonia’s role in ICU outcomes and implications for ICU management. These findings suggest the need for comprehensive assessment strategies in CCU settings
Description
This study explores the relationship between delirium and catatonia in cardiac care unit (CCU) patients. Delirium is associated with worse ICU outcomes, while the role of catatonia remains unclear. The findings stress the need for dual screening to improve diagnosis and intervention, potentially reducing length of stay. This presentation will offer insights into clinical management strategies to optimize ICU care.