{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T02:27:08Z","timestamp":1772504828852,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Despite recent advances in the field, the association between subsyndromal delirium (SSD) in the ICU and poor outcomes is not entirely clear. We performed a retrospective multicentric observational study analyzing mental status during the first 72 h of ICU stay. Of the 681 patients included, SSD occurred in 22.7%. Considering the worst cognitive assessment during the first 72 h, 233 (34%) patients had normal mental status, 124 (18%) patients had SSD and 324 (48%) patients had delirium or coma. SSD was not independently associated with an increased risk of death when compared with normal mental status (OR 95%IC 1.0 vs. 1.35 [0.73\u20131.49], p = 0.340), but was associated with a longer ICU LOS (7.0 (4\u201312) vs. 4 (3\u20138) days, p &lt; 0.001). SSD patients who deteriorated to delirium or coma (21%) had a longer ICU LOS in comparison with those who improved or maintained mental status (8 (5\u201311) vs. 6 (4\u20138) days, p = 0.025), but did not have an increase in mortality. The main factors associated with the progression from SSD to delirium or coma were the use of mechanical ventilation, the use of intravenous benzodiazepines and a baseline APACHE II score &gt; 23 points. Our findings support the association of SSD with increased ICU LOS, but not with ICU mortality. Monitoring the trajectory of SSD early at ICU admission can help to identify patients with increased risk of conversion from SSD to delirium or coma.<\/jats:p>","DOI":"10.3390\/jcm11226797","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T06:19:01Z","timestamp":1668665941000},"page":"6797","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay"],"prefix":"10.3390","volume":"11","author":[{"given":"Rodrigo B.","family":"Serafim","sequence":"first","affiliation":[{"name":"Instituto D\u2019Or de Pesquisa e Ensino, Rio de Janeiro 22281-100, Brazil"},{"name":"Hospital Copa D\u2019Or, Rio de Janeiro 22031-011, Brazil"},{"name":"Hospital Universit\u00e1rio Clementino Fraga Filho\/Instituto de Doen\u00e7as do T\u00f3rax, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3003-8977","authenticated-orcid":false,"given":"Felipe","family":"Dal-Pizzol","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Fisiopatologia experimental, Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Universidade do Extremo Sul Catarinense, Crici\u00fama 88806-000, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1865-1704","authenticated-orcid":false,"given":"Vicente","family":"Souza-Dantas","sequence":"additional","affiliation":[{"name":"Instituto D\u2019Or de Pesquisa e Ensino, Rio de Janeiro 22281-100, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-6088","authenticated-orcid":false,"given":"Marcio","family":"Soares","sequence":"additional","affiliation":[{"name":"Instituto D\u2019Or de Pesquisa e Ensino, Rio de Janeiro 22281-100, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Cl\u00ednica M\u00e9dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4878-0256","authenticated-orcid":false,"given":"Fernando A.","family":"Bozza","sequence":"additional","affiliation":[{"name":"Instituto de Pesquisa Cl\u00ednica Evandro Chagas, FIOCRUZ, Rio de Janeiro 22281-100, Brazil"}]},{"given":"Pedro","family":"P\u00f3voa","sequence":"additional","affiliation":[{"name":"Unidade de Cuidados Intensivos Polivalente, Hospital de S\u00e3o Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, 1150-199 Lisboa, Portugal"},{"name":"NOVA Medical School, CEDOC, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal"},{"name":"Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, C 5000 Odense, Denmark"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7784-9905","authenticated-orcid":false,"given":"Ronir Raggio","family":"Luiz","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Cl\u00ednica M\u00e9dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil"},{"name":"Instituto de Sa\u00fade Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-592, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3116-0253","authenticated-orcid":false,"given":"Jos\u00e9 R.","family":"Lapa e Silva","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Clementino Fraga Filho\/Instituto de Doen\u00e7as do T\u00f3rax, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Cl\u00ednica M\u00e9dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8164-1453","authenticated-orcid":false,"given":"Jorge I. F.","family":"Salluh","sequence":"additional","affiliation":[{"name":"Instituto D\u2019Or de Pesquisa e Ensino, Rio de Janeiro 22281-100, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Cl\u00ednica M\u00e9dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.hrtlng.2018.04.005","article-title":"Delirium after cardiac surgery. Incidence, phenotypes, predisposing and precipitating risk factors, and effects","volume":"47","author":"Sanson","year":"2018","journal-title":"Heart Lung"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.iccn.2018.02.010","article-title":"Frequency and risk factors for subsyndromal delirium in an intensive care unit","volume":"47","author":"Yamada","year":"2018","journal-title":"Intensive Crit. 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