title: Factors associated with onset of delirium among internal medicine inpatients in Spain.
abstract: BACKGROUND
  Delirium increases mortality and length of stay among hospital inpatients. Little is known about the incidence of delirium among inpatients receiving care in internal medicine nursing units in Spain.
  
  
  OBJECTIVE
  The aim of this study was to estimate frequency of delirium onset among internal medicine inpatients and identify factors associated with delirium onset using nursing records and administrative databases.
  
  
  METHODS
  Retrospective cohort study of 744 patients hospitalized in an internal medicine department in October 2010 and January, May, and October 2011. Data concerning occurrence of delirium, age, gender, living in a nursing residence, Barthel Index of activities of daily living, Norton scale for pressure ulcer risk, intravenous fluid therapy, urinary catheterization, presence of pressure ulcers, major diagnostic category at discharge, length of stay, and mean weight in the diagnosis-related group were gathered for each patient. Backward stepwise logistic regression was used to identify factors associated with onset of delirium.
  
  
  RESULTS
  Ninety-seven (13%) patients experienced delirium. Factors associated with delirium were age (OR = 1.03, 95% CI [1.01, 1.06]), Barthel Index (OR = 0.99. 95% CI [0.98, 0.99]), and urinary catheterization (OR = 2.00, 95% CI [1.19, 3.68]).
  
  
  CONCLUSIONS
  Increased age and presence of a urinary catheter were associated with increased onset of delirium, whereas higher levels of independence in activities of daily living were protective.
authors.affiliation: Jesús Díez-Manglano, MD, PhD, is Staff Doctor, Internal Medicine Department, Hospital Royo Villanova, and Main Researcher of the Research Group on Comorbidity and Polypathology, Aragón Health Sciences Institute, Zaragoza, Spain. Esther Del Corral-Beamonte, MD, is Staff Doctor, Internal Medicine Department, Hospital Royo Villanova, Zaragoza, Spain. Claudia Palazón-Fraile, RN, is Staff Nurse; Fabiola Díez-Massó, RN, is Staff Nurse; Rosa Martínez-Álvarez, MD, PhD, is Staff Doctor; Pilar Carreño-Borrego, RN, is Staff Nurse; Pilar Pueyo-Tejedor, RN, is Staff Nurse; Javier Gomes-Martín, MD, is Resident Doctor, Internal Medicine Department, Hospital Royo Villanova, Zaragoza, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Díez-Manglano
authors.forename: Claudia
authors.initials: C
authors.lastname: Palazón-Fraile
authors.forename: Fabiola
authors.initials: F
authors.lastname: Diez-Massó
authors.forename: Rosa
authors.initials: R
authors.lastname: Martínez-Álvarez
authors.forename: Esther
authors.initials: E
authors.lastname: Del Corral-Beamonte
authors.forename: Pilar
authors.initials: P
authors.lastname: Carreño-Borrego
authors.forename: Pilar
authors.initials: P
authors.lastname: Pueyo-Tejedor
authors.forename: Javier
authors.initials: J
authors.lastname: Gomes-Martín
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000453:epidemiology*; D005260:Female; D006757:Hospital Units; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D014546:Urinary Catheterization