Prevalence and Risk Factors of Pediatric Delirium in Critically Ill Children: A Study Using Cornell Assessment of Pediatric Delirium Tool at a Tertiary Care Hospital

Background and aims: The Cornell Assessment of Pediatric Delirium (CAPD)-revised is a validated tool for detecting delirium in critically ill children.This study aimed to determine the prevalence of delirium and associated risk factors in a pediatric intensive care population using CAPD.Materials and methods: A descriptive cross-sectional study was conducted among 201 critically ill children aged 1 month-14 years admitted to a tertiary care hospital in Karachi, Pakistan, from August 2021 to February 2022.Delirium was assessed twice daily for three consecutive days using CAPD.A score of 9 was considered diagnostic.Results: Delirium was identified in 24.9% of patients (n = 50/201).The mean age was 5.14 4.03 years, with 61.7% male (n = 124/201).Significant risk factors included comorbidities (n = 34/201, OR = 3.45, 95% CI: 1.78-6.70,p = 0.0005), developmental delay (n = 3/201, OR = 5.12, 95% CI: 1.34-19.54,p = 0.015), benzodiazepine use (n = 45/201, OR = 2.89, 95% CI: 1.52-5.50,p = 0.001), antiepileptic use (n = 38/201, OR = 2.67, 95% CI: 1.38-5.17,p = 0.004), high-flow oxygen (n = 60/201, OR = 2.31, 95% CI: 1.20-4.45,p = 0.012), and mechanical ventilation (n = 55/201, OR = 3.12, 95% CI: 1.62-6.01,p = 0.001).Conclusion: Delirium affected nearly one-quarter of critically ill children, with comorbidities, developmental delay, use of sedatives, and advanced respiratory as key risk factors.Cornell Assessment of Pediatric Delirium is a valuable tool for routine screening to enable early recognition and management of pediatric delirium.More multicenter studies are recommended for further validation.