Table 1.

MRI findings and neuropsychological scores when clinicians ordered an MRI specifically for delirium^a

CASE	DIAGNOSIS	AGE	IQCODE SCOREb	COMORBIDITIES	APACHE-II SCOREc	SOFA SCOREd	CLINICAL REASON FOR IMAGING	LOS SINCE ICU ADMISSION AND DAYS OF DELIRIUM PRIOR TO MRIe	MRI FINDINGS: WMH, ATROPHYf	ORDERS FOLLOWING MRI RESULTS	FINAL REPORTED DELIRIUM DIAGNOSIS	3-MONTH FOLLOW UPf
1	Septic shock	43	<3.3	None	20	13	Delirium, normal CT scan	13 days of LOS, 5 days of delirium	Grade 2 No atrophy	Neurology consult, EEG and psychiatry consult	Medical delirium	Ex Func 0.1
2	Acute lung injury	75	<3.3	Diabetes, CAD COPDg	31	15	Agitation, normal CT	6 days of LOS, 12 days of delirium	Grade 2 No atrophy	Haloperidol, Olanzapine	Delirium due to hypoxia	Memory 32 Ex Func 0.1 Attention 16
3	ARDS	35	<3.3	None	31	15	Delirium, normal CT	9 days of LOS, 3 days of delirium	None No atrophy	Neurology consult, EEG and psychiatry consult	Delirium due to hypoxia	Memory 13 Ex Func 0.1 Attention 1
4	Septic shock	57	<3.3	None	27	14	Delirium, normal CT	7 days of LOS, 5 days of delirium	Grade 1 No atrophy	None	Delirium with negative MRI	Memory NA Ex Func 13 Attention 27
5	Acute respiratory failure due to pleural effusion	65	<3.3	Diabetes, HTN, OSA, CHFg	30	10	AMS, normal CT	2 days of LOS, 2 days of delirium	Grade 3 No atrophy	Neurology consult, EEG	Delirium due to hypercarbia	Patient died in the hospital
6	Septic shock	52	<3.3	HTN, CAD, HIVg	25	13	AMS, CT (mild atrophy)	13 days of LOS, 4 days of delirium	Grade 1 No atrophy	None	Medical delirium	Memory 42 Ex Func 13 Attention 27
7	Baclofen overdose	22	<3.3	None	15	11	AMS, normal CT	3 days of LOS, 3 days of delirium	No atrophy	Psychiatry consult	Delirium due to baclofen withdrawal	Not available
8	Septic shock	81	<3.3	None	22	13	Delirium, normal CT	2 days of LOS, 2 days of delirium	Grade 3 No atrophy	Interruption of sedationa	Medical delirium	Memory 53 Ex Func 55 Attention 58

^aThe clinical indication to perform an MRI for these patients was delirium. Patients for whom an MRI was ordered for the presence of focal neurological symptoms, ischemia at CT scan, coma, and central nervous system infections were not included in this table. All the patients included in this table were found delirious on the day of the MRI by research staff performing the CAM-ICU evaluation.

^bThe presence of cognitive impairment before hospitalization was determined via the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) at study enrollment. None of the patients included in this table had a baseline cognitive impairment (i.e., IQCODE <3.3).

^cAPACHE-II (Acute Physiology and Chronic Health Evaluation II).

^dSOFA (Sequential Organ Failure Assessment).

^eLength of stay (LOS), Intensive Care Unit (ICU).

^fWMH (white matter hyperintensities) were classified from 0 to 3, based on the number and size of lesions: grade 0 (normal); grade 1 (punctiform), grade 2 (patchy or confluent), and grade 3 (diffuse) according to a previously validated scale.^12,13

^fNPS (Neuropsychological assessment performed at 3-month follow-up): memory (assessed with RBANS delayed call), executive functions (assessed with TRAILS B), attention (assessed with digit symbol).¹⁸ The test scores are reported in percentile, adjusted for age, education and race based on normative databases.

^gCAD (coronary artery disease), COPD (chronic obstructive pulmonary disease), HTN (arterial hypertension), OSA (obstructive sleep apnea), CHF (congestive heart failure), HIV (human immunodeficiency virus).