Evaluating dopamine D2 receptor gene polymorphisms and peripheral inflammatory cytokines in ICU delirium: a two-stage exploratory observational study

The study examined the association between specific genetic variants of the dopamine D2 receptor (rs6275 and rs6277) and delirium development in 200 ICU patients. Delirium developed in 28 patients (14 percent). Genetic testing showed that the rs6277 CC genotype was associated with increased delirium risk with an odds ratio of 2.851. In a subset of 100 patients, inflammatory marker TNF-alpha levels were significantly higher in delirious patients. Mechanical ventilation strongly increased delirium risk (odds ratio 6.842), while dexmedetomidine administration reduced risk (odds ratio 0.371). The results support both genetic and inflammatory hypotheses of ICU delirium development.