An ACE unit with a delirium room may improve function and equalize length of stay among older delirious medical inpatients.
BACKGROUND
Patients with delirium, compared with those without, are at increased risk for loss of function, longer hospital stays, and increased mortality. We studied the effect that an Acute Care of the Elderly Unit, which includes a delirium room, has on patients with delirium.


METHODS
Retrospective observational study. Charts of 148 patients (≥65 years) admitted to an Acute Care of the Elderly Unit with a delirium room during a 4-month period were reviewed. Delirium on admission (prevalence) was based on physician-performed Confusion Assessment Method; delirium during hospital stay (incidence) was based on nurse-performed Confusion Assessment Method. Patients with delirium were compared with those without delirium regarding change in function between admission and discharge (activities of daily living), hospital length of stay, and mortality.


RESULTS
The prevalence of delirium was 16.2% (24/148), and the incidence was 16.1% (20/124). There were no significant differences between delirious and non-delirious patients in demographics or comorbidity scores. A significant interaction effect (p < .001) indicated improved activities of daily living (mean ± SD; scale 0-12) between admission and discharge among delirious patients (4.1 ± 4.6 and 6.1 ± 3.9) compared with non-delirious patients (7.4 ± 4.7 and 6.9 ± 4.5). There were no differences between delirious and non-delirious patients with reference to mean length of stay (6.4 ± 3.1 vs 5.9 ± 3.6 days, respectively; p = .461) and mortality (2 [4.5%] versus 2 [1.9%], respectively; p = .582).


CONCLUSIONS
Although this study sample was small, the results suggest that an Acute Care of the Elderly Unit with a delirium room may improve function among delirious patients and may equalize other outcomes compared with non-delirious patients.
Flaherty
Joseph H
JH
Geriatric Research, Education and Clinical Center, St. Louis VA Medical Center, and Department of Internal Medicine & Division of Geriatrics, Saint Louis University School of Medicine, 1402 S. Grand Blvd., St. Louis, MO 63104, USA. flaherty@slu.edu
Steele
D Kimberly
DK
Chibnall
John T
JT
Vasudevan
Vijaya N
VN
Bassil
Nazem
N
Vegi
Srivalli
S
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D015994:Incidence; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D010348:Patient Care Team; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome