ICU sedation, delirium & recovery
Association between acute kidney injury and delirium in critically ill patients: a retrospective cohort study using two independent databases
Authors' conclusion
Acute kidney injury was associated with a higher risk of subsequent delirium in critically ill patients, with a graded association across AKI severity stages.
Study context
- Population
- Adult ICU patients, LOS > 12 h, with Confusion Assessment Method for the ICU (CAM-ICU) delirium monitoring; MIMIC-IV and University Hospital Münster (Reality) databasesMIMIC-IV n = 15,219
- Exposure
- Acute kidney injury (AKI) vs no AKI at 24 h after ICU admission
- Outcome
- Subsequent delirium (positive CAM-ICU) during ICU stay
Methodological detailstwo independent databases, landmark analysis at 24 h, propensity score matching, Fine-Gray model
- Two independent databases
- Landmark analysis at 24 h
- Propensity score matching
- Fine-Gray model
Main finding
As reported in the abstract
Subsequent delirium
AKI vs No AKIEstimate (95% CI)P value
MIMIC-IV, unadjusted
OR 1.84(1.68–2.04)
P < 0.001Reality, unadjusted
OR 1.95(1.44–2.64)
P < 0.001MIMIC-IV, adjusted
aOR 1.16(1.10–1.23)
Reality, adjusted
aOR 1.20(1.01–1.41)
Observational data: associations, not effects.
Further findings
Delirium by AKI stage (biological gradient)
| aOR | |
|---|---|
| Stage 1MIMIC-IV | 1.42 |
| Stage 3MIMIC-IV | 4.11 |
| OR | |
|---|---|
| Stage 1Reality | 1.01 |
| Stage 3Reality | 1.92 |
| Outcome | Trend OR | P value |
|---|---|---|
| Delirium by AKI stage (biological gradient)Per stage · MIMIC-IV | 1.55 | P < 0.001 |
| Delirium by AKI stage (biological gradient)Per stage · Reality | 1.25 | P < 0.01 |
Delirium by AKI stage (biological gradient)
- Delirium rates increased progressively across AKI stages
Propensity score matched analysis
- Propensity score matching confirmed these findings
Original publication
Association between acute kidney injury and delirium in critically ill patients: a retrospective cohort study using two independent databases. Crit Care. Published 5 March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →