title: Risk factors for developing delirium in older patients admitted to general medical wards.
abstract: BACKGROUND
  Delirium in older patients is common and leads to poor clinical outcomes. It is, however, preventable if its risk factors are identified and modified accordingly.
  
  
  OBJECTIVE
  To determine risk factors associated with delirium in hospitalized older patients admitted to general medical wards at Siriraj Hospital.
  
  
  METHODS
  A prospective observational study was conducted at general medical wards, Siriraj Hospital. All consecutive patients aged 70 years or older admitted during study period were assessed and followed until discharge. A diagnosis of delirium was made if patients developed symptoms which fulfilled DSM IV criteria. Information regarding demographic data, co-morbid illnesses, preexisting cognitive status and functional status was collected at admission. Factorf associated with delirium were analyzed using logistic regression models.
  
  
  RESULTS
  Risk factors associated with developing delirium identified from univariate analysis were female gender, age more than 80 years-old, having 4 or more co-morbidities, azothemia, hyponatremia, presence of infection, severe illness, preexisting dementia, depression, and impaired basic activities of daily living. After adjusted in multivariate analysis; factors those remained statistically significant were preexisting dementia (OR = 5.52, 95% CI = 2.51-12.14), severe illness (OR = 5.18, 95% CI = 2.10-12.76) presence of infection (OR = 2.54, 95% CI = 1.15-5.61) and azothemia (OR = 2.55, 95% CI = 1.205.40).
  
  
  CONCLUSIONS
  Pre-existing dementia and illness severity were strongly associated with developing delirium in older patients in the present study, which is concordant with previous studies. Other factors such as presence of infection and azothemia are modifiable factors that could potentially be important targets, along with other factors identified in the present study, for implementing intervention in order to prevent delirium in this population.
authors: Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. tevsn@mahidol.ac.th
authors: Varalak
authors: V
authors: Srinonprasert
authors: Sorapop
authors: S
authors: Pakdeewongse
authors: Jintana
authors: J
authors: Assanasen
authors: Waricha
authors: W
authors: Eiamjinnasuwat
authors: Achara
authors: A
authors: Sirisuwat
authors: Duangsawang
authors: D
authors: Limmathuroskul
authors: Rungnirand
authors: R
authors: Praditsuwan
mesh_terms: D000203:Activities of Daily Living; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013785:Thailand / Q000453:epidemiology