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Impact of Religiosity on Delirium Severity Among Critically Ill Shi'a Muslims: A Prospective Multi-Center Observational Study.

Authors
  • Farzanegan, Behrooz1
  • Elkhatib, Takwa H M2
  • Elgazzar, Alaa E3
  • Moghaddam, Keivan G4
  • Torkaman, Mohammad5
  • Zarkesh, Mohammadreza6
  • Goharani, Reza7
  • Bashar, Farshid R8
  • Hajiesmaeili, Mohammadreza7
  • Shojaei, Seyedpouzhia7
  • Madani, Seyed J9
  • Vahedian-Azimi, Amir10
  • Hatamian, Sevak11
  • Mosavinasab, Seyed M M12
  • Khoshfetrat, Masoum13
  • Khatir, Ali K14
  • Miller, Andrew C15
  • 1 Tracheal Diseases Research Center, Anesthesia and Critical Care Department, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , (Iran)
  • 2 Department of Neurology, Zagazig University, Sharkia, Egypt. , (Egypt)
  • 3 Department of Chest Diseases, Zagazig University, Sharkia, Egypt. , (Egypt)
  • 4 Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. , (Iran)
  • 5 Department of Pediatrics, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. , (Iran)
  • 6 Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. , (Iran)
  • 7 Anesthesiology Research Center, Anesthesia and Critical Care Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , (Iran)
  • 8 Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, Iran. , (Iran)
  • 9 Trauma Research Center, Medicine Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. , (Iran)
  • 10 Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. , (Iran)
  • 11 Anesthesia and Critical Care Department, Alborz University of Medical Sciences, Karaj, Iran. , (Iran)
  • 12 Anesthesiology Research Center, Anesthesia Care Department, Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , (Iran)
  • 13 Anesthesiology Research Center, Anesthesia and Critical Care Department, Khatam-o-anbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. , (Iran)
  • 14 Anesthesiology Research Center, Anesthesia and Critical Care Department, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , (Iran)
  • 15 Department of Emergency Medicine, Vidant Medical Center, East Carolina University Brody School of Medicine, 600 Moye Blvd, Greenville, NC, 27834, USA. [email protected]
Type
Published Article
Journal
Journal of Religion and Health
Publisher
Springer-Verlag
Publication Date
Apr 01, 2021
Volume
60
Issue
2
Pages
816–840
Identifiers
DOI: 10.1007/s10943-019-00895-7
PMID: 31435840
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This study assesses the impact of religiosity on delirium severity and patient outcomes among Shi'a Muslim intensive care unit (ICU) patients. We conducted a prospective observational cohort study in 21 ICUs from 6 Iranian academic medical centers. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU) tool. Eligible patients were intubated, receiving mechanical ventilation (MV) for ≥ 48 h. Illness severity was assessed using Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. A total of 4200 patients were enrolled. Patient religiosity was categorized as more (40.6%), moderate (42.3%), or less (17.1%) based on responses to patient and surrogate questionnaires. The findings suggest that lower pre-illness religiosity may be associated with greater delirium severity, MV duration, and ICU and hospital LOS. The lower mortality in the less religiosity group may be related in part to a greater proportion of female patients, but it remains unclear whether and to what extent greater religiosity impacted treatment decisions by patients and families. Further investigation is needed to validate and clarify the mechanism of the mortality findings.

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