Young African-American Adults Are Less Susceptible to Delirium in ICU Than Caucasians

The first study to evaluate the relationship between race and intensive care unit delirium has found that African-American ICU patients age 18 to 50 are less susceptible to delirium than similarly aged Caucasians or than either African-American or Caucasian ICU patients age 50 or older.

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“Relationship between African-American Race and Delirium in the Intensive Care Unit” is published online ahead of print in the journal Critical Care Medicine.

“Since African-Americans tend to have higher disease severity in the ICU, we were surprised to find that race could be a protective factor for younger African-American adults,” said Regenstrief Institute investigator and IU Center for Aging Research scientist Babar A. Khan, M.D., M.S., the first author of the study.

“We now know that race should be considered among the risk factors for developing delirium for Caucasians of all ages but only for African-Americans if they are 50 or older. Clearly, different groups have different risk profiles for delirium.”

A total of 2,087 adults, admitted to a medical or surgical ICU, 48 percent of whom were African-Americans, participated in the study. The majority participated in an indigent care program or state Medicaid program and were thus considered to be of similar economic status. All had ready access to healthcare services and delivery at Eskenazi Health, a healthcare system that puts special emphasis on vulnerable populations in the metropolitan Indianapolis area. Dr. Khan is the medical director of the Eskenazi Health Critical Care Recovery Center.

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“If you look at various studies, there are certain medications to which African-Americans respond better and from which they have better outcomes compared to Caucasians,” Dr. Khan said. “If in the near future we are able to learn more about delirium at a basic or molecular level utilizing genetics and biomarkers, we may be able to come up with better preventive and treatment strategies based on personalization of therapy. Our findings provide the kind of information we need to conduct precision medicine.”

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