Delirium in hospitalized elderly patients and post-discharge mortality.
OBJECTIVE
To determine the impact of delirium on post-discharge mortality in hospitalized older patients.


BACKGROUND
Delirium is frequent in hospitalized older patients and correlates with high hospital mortality. There are only a few studies about its impact on post-discharge mortality.


METHODS
This is a prospective study of patients over 60 years old who were hospitalized in the Geriatric Unit at Hospital das Clínicas of São Paulo between May 2006 and March 2007. Upon admission, demographics, comorbidities, number of drugs taken, and serum albumin concentration were evaluated for each patient. Delirium was diagnosed according to the DSM-IV criteria. Patients were divided into group A (with delirium) and group B (without delirium). One year after discharge, the patients or their caregivers were contacted to assess days of survival.


RESULTS
The sample included 199 patients, 66 (33%) of whom developed delirium (Group A). After one year, 33 (50%) group A patients had died, and 45 (33.8%) group B patients had died (p = 0.03). There was a significant statistical difference in average age (p = 0.001) and immobility (p <0.001) between groups A and B. There were no statistically significant differences between groups A and B in number of drugs taken greater than four (p = 0.62), sex (p = 0.54) and number of diagnoses greater than four (p = 0.21). According to a multivariate analysis, delirium was not an independent predictor of post-discharge mortality. The predictors of post-discharge mortality were age > or = 80 years (p = 0.029), albumin concentration < 3.5 g/dl (p = 0.001) and immobility (p = 0.007).


CONCLUSIONS
Delirium is associated with higher post-discharge mortality as a dependent predictor.
Lima
Danielle Pessoa
DP
Hospital Auxiliar de Cotoxó - São Paulo/SP, Brazil. dra.daniellelima@gmail.com
Ochiai
Marcelo Eidi
ME
Lima
Alexandre Bastos
AB
Curiati
Jose A E
JA
Farfel
Jose M
JM
Filho
Wilson Jacob
WJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015986:Confounding Factors, Epidemiologic; D003693:Delirium / Q000097:blood / Q000209:etiology / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010351:Patient Discharge; D012709:Serum Albumin / Q000032:analysis
D012709:Serum Albumin