Prevalence of delirium and urinary tract infection in a psychogeriatric unit.
A retrospective study involving 407 patients discharged over a 2-year period from a psychogeriatric unit found that 83 (20.4%) had urinary tract infection (UTI) and 54 (13.3%) had delirium diagnoses at admission. Of the 54 with delirium, 14 (25.9%) had UTI. Of these 14 patients, delirium cleared in nine (64.3%) after appropriate treatment of UTI, two (14.3%) improved with treatment of concomitant medical disorders, and three (21.4%) did not improve. Only six of the 14 (42.8%) showed symptoms of UTI, with only one of the 14 (7.1%) showing fever and leukocytosis. Urine analyses were abnormal in all cases with 13/14 (92.8%) having positive cultures. Dementia was an associated risk factor in 71.4% of the 14 patients with UTI and delirium. Clinicians need to have a high index of suspicion relative to the presence of UTI in the elderly, especially with pre-existing cognitive impairment, since it can precipitate delirium. Early recognition and appropriate treatment decreases morbidity.
Manepalli
J
J
Department of Psychiatry and Human Behavior, St Louis University School of Medicine, MO 63104.
Grossberg
G T
GT
Mueller
C
C
D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D011567:Psychiatric Department, Hospital; D014552:Urinary Tract Infections / Q000150:complications* / Q000175:diagnosis / Q000523:psychology