Delirium, a neurologic syndrome characterized by fluctuating impairments in consciousness and cognition, is commonly observed in conjunction with severe illness. Up to 80% of patients in intensive care units (ICU) develop delirium, and delirium is a strong predictor of higher mortality and poor functional outcomes among survivors. It is not known whether delirium is simply a surrogate marker for greater disease severity and other predictors of poor outcome (like increasing age) or a distinct mediator of morbidity. Recent research has identified an association between delirium and dysfunction in the circadian rhythm--the neural process that regulates sleep, wake, and a myriad of basic immune system and other organ functions. We seek to test the hypothesis that circadian dysfunction is associated with poor neurologic outcomes, thus establishing a physiologic mechanism for the harm seen in conjunction with delirium and a potential target of novel therapies. We will study patients in the ICU with brain hemorrhage and will assess for delirium and circadian dysfunction using neurophysiologic sensors and blood sampling for melatonin levels. We will use well established risk adjustment techniques to isolate the contributory effect of circadian dysfunction on multiple domains of neurologic function after three months of recovery.
|Effective start/end date||1/1/14 → 12/31/16|
- Northwestern Memorial Hospital (Exhibit B.6)