The Relationship Between Thirst and the Incidence of Delirium in Patients Admitted to Intensive Care Units: A Cross Sectional Study.

Background and Aims: Delirium is an acute cognitive fluctuation commonly observed in intensive care units (ICUs) and influenced by multiple factors. Identifying these factors is crucial for effective prevention and management. This study aimed to examine the relationship between thirst and the incidence of delirium in adult ICU patients. Methods: This cross-sectional study was conducted in 2022 on adult patients admitted to ICUs of hospitals affiliated with Kurdistan University of Medical Sciences, Iran. Thirst intensity was assessed using the validated Visual Analogue Scale (VAS), sedation/agitation by Richmond Agitation-Sedation Scale (RASS), and delirium incidence was measured by the Confusion Assessment Method for the ICU (CAM-ICU). Results: A total of 118 patients participated (59% male; mean age 46 years). Delirium was observed in 22.43% of patients. Thirst intensity was reported as mild by 51.69%, moderate by 29.66%, and severe by 18.64%. Delirium was significantly associated with increased thirst intensity, with moderate and severe thirst increasing the risk of delirium by approximately 4 and 14 times, respectively. Additionally, dehydration Statistical significant increased delirium risk by more than 10 times. Statistical significant associations were also found between delirium and biochemical markers such as blood urea nitrogen (BUN), creatinine (Cr), sodium, and plasma osmolality. Conclusion: ICU nurses should systematically assess and document key delirium risk factors, especially thirst, using validated tools such as VAS. Evidence-based nonpharmacological strategies should be implemented for delirium prevention and management. Nurses must closely monitor laboratory parameters including BUN/Cr ratio, serum sodium, and plasma osmolarity, and promptly report abnormalities to physicians. Correction of hypernatremia or hyperosmolarity should be done under physician supervision; nurses facilitate early recognition and medical intervention but do not independently administer electrolyte-correcting treatments.