{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:43:32Z","timestamp":1789177412509,"version":"build-2803163510"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Survivors of critical illness often have ongoing issues that affect functioning, including driving ability.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine whether intensive care unit (ICU) delirium is independently associated with long-term changes in driving behaviors.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This multicenter, longitudinal cohort study included 151 survivors of critical illness residing within 200 miles of Nashville, Tennessee. Survivors were surveyed 2 to 6 years after critical illness to assess the association between delirium duration and driving skills and behaviors (July 1, 2012, to April 30, 2013), and data were analyzed in 2014.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary and secondary outcomes were self-rated driving skill (Driver Skill Inventory) and risky driving behaviors (Mini Driver Behavior Questionnaire), respectively. Exploratory outcomes included changes in driving decisions and driving-related attitudes.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 333 survivors from the original study, 151 (45.3%) were active drivers and agreed to participation at a median (range) of 3.7 (2.1-6.2) years after critical illness (median [IQR] age at enrollment, 59 [50-64] years; 87 [57.6%] male) with a median (IQR) delirium duration of 1 (0-4) day. Driving resumption occurred at a median (IQR) of 1.9 (0.8-6.0) months after ICU discharge. Delirium duration was not independently associated with self-rated driving skill or risky driving behavior measures (regression coefficients of \u22120.10 [95% CI, \u22121.13 to 0.93] for Driver Skill Inventory and\u20130.46 [95% CI, \u22121.97 to 1.06] for Mini Driver Behavior Questionnaire). Driving distances after critical illness were significantly lower than prehospitalization estimates (median [IQR], 60 [25-150] vs 105 [58-250] miles per week; P<\/jats:italic>\u2009&amp;lt;\u2009.001). Driving skill (median [IQR], 34 [26-38] on a 48-point scale; P<\/jats:italic>\u2009&amp;lt;\u2009.001) and safety orientation measures (median [IQR], 38 [35-46] on a 48-point scale; P<\/jats:italic>\u2009&amp;lt;\u2009.001) were significantly lower upon return to driving. These decrements persisted among adults 65 years and older.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of survivors of critical illness, ICU delirium was not independently associated with long-term changes in driving behaviors after critical illness; survivors of critical illness self-reported significant decreases in transportation independence and driving skill after hospital discharge, independent of delirium duration during hospitalization. These results suggest that clinicians should consider transportation-related limitations relevant to short- and long-term care planning.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.31224","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T15:00:35Z","timestamp":1757516435000},"page":"e2531224","source":"Crossref","is-referenced-by-count":1,"title":["Delirium and Self-Reported Driving Behaviors and Outcomes After Critical Illness"],"prefix":"10.1001","volume":"8","author":[{"given":"Valerie","family":"Danesh","sequence":"first","affiliation":[{"name":"Baylor Scott & White Research Institute, Dallas, Texas"},{"name":"Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany D.","family":"Work","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise F.","family":"Chen","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Department of Neurology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Van","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew F.","family":"Mart","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville"},{"name":"Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Welch","sequence":"additional","affiliation":[{"name":"Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville"},{"name":"Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Wesley","family":"Ely","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Veterans Affairs Tennessee Valley Geriatric Research Education and Clinical Center, Nashville"},{"name":"Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawniqua Williams","family":"Roberson","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, 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