Prevalence of delirium in a geriatric convalescence hospitalization unit: patient's clinical characteristics and risk precipitating factor analysis.
The aim was to evaluate the prevalence of delirium among patients discharged from an acute care hospital and admitted to a geriatric convalescence unit (GCU), and to analyze patient's characteristics and risk precipitating factors. Sixty-eight patients were analyzed during a 2-week period. The confusion assessment method (CAM) was used to detect delirium. The precipitating factors evaluated were: major surgery-intensive care unit(ICU) stay, pulmonary and heart failure, acute infections, metabolic disorders/anemia,psychoactive medications, other drugs, severe pain, changing environmental influences and others. According to CAM, fifteen patients presented delirium (22%), and in 14 of them(93.3 %) the delirium was developed before admission at GCU. The precipitating factors in the studied population were the following: changing environmental influences in 66 patients(97%) (15 with delirium and 51 without delirium); other drugs 56 (82.3 %) (11 vs. 45);others 56 (82.3%) (9 vs. 24); psychoactive medications 50 (73.5%) (12 vs. 38); acute infections 48 (70.5 %) (13 vs. 35); metabolic disorders/anemia 40 (58.8 %) (9 vs. 31); major surgery-ICU stay 28 (41 .1%) (8 vs. 20); severe pain 26 (38.2%) (6 vs. 20); pulmonary and heart failure 22 (32.3%) (5 vs. 17). The univariant analysis showed that, none of the precipitating factors studied was significantly related to delirium. Seventy-two patients (91.1%) had simultaneously >3 precipitating factors. There were 16 patients with >6 precipitating factors, 7 of 15 with delirium and 9 of the 53 without delirium (46.6 % vs 16.9 %) (p < 0.05). The prevalence of delirium has been 22 %. Most of the patients had developed delirium before the admission at GCU. A high proportion of patients had >3 precipitating factors. In the study the presence of > 6 precipitating factors simultaneously has been significantly related to delirium.
Pi-Figueras
M
M
Universidad Autónoma de Barcelona, Servicio de Geriatría del IMAS, I-08022 Barcelona, Spain. Mpi-figueras@imas.imim.es
Aguilera
A
A
Arellano
M
M
Miralles
R
R
Garcia-Caselles
P
P
Torres
R
R
Cervera
A M
AM
D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003289:Convalescence; D003693:Delirium / Q000188:drug therapy / Q000453:epidemiology* / Q000534:rehabilitation*; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006748:Hospital Departments; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012307:Risk Factors; D012720:Severity of Illness Index
D011619:Psychotropic Drugs