Study: Blacks less susceptible than whites to delirium in ICU

Black patients under age 50 in the ICU are at significantly lower risk for delirium than white patients under age 50 and all patients over 50.

By Stephen Feller

INDIANAPOLIS, June 14 (UPI) -- During treatment in the intensive care unit, younger black patients are at a lower risk for delirium than white patients, regardless of the reason they were there, according to a recent study.

Researchers at the University of Indiana found in a review of patients at Eskenazi Health white patients at any age were at risk for delirium, but that black patients under age 50 appear to be at lower risk.


The researchers say they are unsure why black patients would be at lower risk than white patients, though higher incidence of depression and more drugs associated with delirium are used with white patients. These were among a small number of differences in outcome after ICU treatment, the researchers report.

"If you look at various studies, there are certain medications to which African-Americans respond better and from which they have better outcomes compared to Caucasians," Dr. Babar Khan, a researcher at the University of Indiana's Center for Aging Research, said in a press release. "If in the near future we are able to learn more about delirium at a basic or molecular level utilizing genetics and biomarkers, we may be able to come up with better preventive and treatment strategies based on personalization of therapy. Our findings provide the kind of information we need to conduct precision medicine."


For the study, published in the journal Critical Care Medicine, researchers reviewed medical records for 2,087 patients treated at ICU between May 2009 and August 2012, 48 percent of whom were African American.

Overall, the rate for incident delirium was 8.7 percent for black patients and 10.4 percent for white patients, although the rate for prevalent delirium was the same, 14 percent, for black and white patients. Researchers report age and race were factors in incident delirium but not prevalent delirium. Among age groups, black patients age 18 and 49 were at lower risk, researchers report.

The majority of participants participated in Medicaid or indigent care programs and were considered to be of similar socioeconomic status. The black and white participants had comparable death rates, illness severity and similar rates of mechanical ventilation and dementia diagnoses. Smoking and depression diagnosis were greater among white patients.

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"Since African-Americans tend to have higher disease severity in the ICU, we were surprised to find that race could be a protective factor for younger African-American adults," Khan said. "We now know that race should be considered among the risk factors for developing delirium for Caucasians of all ages but only for African-Americans if they are 50 or older. Clearly, different groups have different risk profiles for delirium."


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