Incidence and risk factors of delirium in the elderly general surgical patient.
BACKGROUND
This study evaluates the incidence of delirium and risk factors associated with delirium in elderly patients admitted to a general surgical ward.


METHODS
Patients aged over 60 years who were admitted with an acute or elective general surgical diagnosis were eligible for this prospective cohort study. Risk factors associated with delirium were analyzed using univariate and multivariate analysis to identify those independently associated with delirium.


RESULTS
A total of 209 patients were included in the study. The incidence of delirium was 16.9% (23.2% for acute admission, P < .001). Variables associated with delirium were dementia, presence of an urinary catheter, cognitive decline at admission measured with the mini-mental state examination, white blood cell count >10.0 × 10(9)/L, and urea >7.5 mmol/L. Median length of hospital stay was 13 days (range 3-85) for patients with delirium versus 7 (range 1-54) for patients without (P = .002).


CONCLUSIONS
The incidence of delirium is high in elderly patients, especially after an acute admission, leading to an increase in length of hospital stay. To minimize delirium, associated risk factors must be identified and, if possible, treated.
Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands. Electronic address: stevedecastro@me.com.
Steve M M
SM
de Castro
Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
Çağdaş
Ç
Ünlü
Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
Jurriaan B
JB
Tuynman
Department of Psychiatry, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands; Department of Psychiatry, Free University Hospital, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands.
Adriaan
A
Honig
Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
Bart A
BA
van Wagensveld
Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
E Philip
EP
Steller
Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
Bart C
BC
Vrouenraets
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D017558:Elective Surgical Procedures; D005260:Female; D013502:General Surgery; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057234:Preoperative Period; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013514:Surgical Procedures, Operative
Delirium; General surgery; Hip fracture