Association Between Malnutrition and Sepsis-Associated Delirium: A Retrospective Analysis of the MIMIC-IV Database.

BACKGROUND

In individuals with sepsis, the most frequent neurological consequence is sepsis-associated delirium (SAD). SAD can cause long-term neuropsychiatric aftereffects such as anxiety disorders and cognitive impairment in addition to dramatically raising death rates in the intensive care unit (ICU) and during hospital stays. However, the correlation between nutritional status and SAD in patients with sepsis remains undefined.

AIM: To examine the correlation between malnutrition and the incidence of SAD in sepsis patients.

STUDY

DESIGN

This research performed a retrospective analysis of adult patients with sepsis who were admitted to the ICU for the initial time. It investigated the association between malnutrition and delirium using logistic regression analysis. It employed propensity score matching, conducted stratified analysis and utilised E-value for sensitivity analysis.

RESULTS

This study included 25 716 patients, of whom 3132 were classified as malnourished and 22 584 were non-malnourished. The malnourished cohort demonstrated a twofold increased risk of delirium relative to the non-malnourished cohort (26.56% vs. 12.90%). Multifactorial logistic regression demonstrated a significant positive correlation between malnutrition and the occurrence of delirium in sepsis patients within a fully adjusted model (odds ratio [OR] = 2.07, 95% confidence interval [CI] = 1.88-2.29). The findings remained consistent following a series of sensitivity analyses.

CONCLUSION

Malnutrition is strongly correlated with the occurrence of delirium in patients with sepsis. The significance of addressing malnutrition in sepsis patients within the ICU warrants attention.

RELEVANCE TO CLINICAL PRACTICE: ICU nurses should prioritise the assessment of malnutrition, particularly among patients with sepsis. Timely identification and nutritional intervention in these patients may reduce care costs and lower the risk of delirium.