title: Delirium among elderly patients admitted to a post-acute care facility and 3-months outcome.
abstract: OBJECTIVE
  To investigate the prevalence and risk factors of delirium in an extended care unit, the persistence of delirium and 3-month outcome.
  
  
  METHODS
  Patients aged >65 years were recruited. Basic demographic data, medical comorbidity using the Charlson Comorbidity Index, pre-existing cognitive impairment using the informant questionnaire on cognitive decline in the elderly, place of residence and physical function as measured by the modified Barthel Index were recorded. Delirium was assessed by the Confusion Assessment Method and Direct Observation Scale. Delirium status, physical function and placement were reassessed on discharge, and at 1 month and 3 months after discharge.
  
  
  RESULTS
  A total of 261 patients were recruited with a mean age of 81.9 years. Delirium was present in 89 participants (34.1%). Of these, 70 patients continued to be delirious on discharge. A total of 76 patients had persistent delirium at 1 month, and 49 remained to be delirious at 3 months. Pre-existing cognitive impairment (OR 9.12), use of psychoactive drugs (OR 3.61), presence of metabolic disturbances (OR 3.53), acute infection (OR 3.49) and old age home residents (OR 3.04) were associated with delirium on admission. A smaller number of delirium patients can return home on discharge, and they have poorer functional status on admission, at discharge, and at 1 month and 3 months after discharge. Unplanned hospital admission was significantly higher among the delirium group (42.9% vs 24.1%, P < 0.001).
  
  
  CONCLUSIONS
  Delirium in post-acute convalescence units is highly prevalent and persistent. It is associated with poor functional recovery, higher nursing home placement and unplanned hospital admission. These findings reinforce the necessity to implement a program to prevent, early detect and treat delirium in elderly patients admitted to post-acute care units. Geriatr Gerontol Int 2016; 16: 586-592.
authors.affiliation: Department of Rehabilitation and Extended Care, Wong Tai Sin Hospital, Hong Kong.
authors.forename: Doris Ka Ying
authors.initials: DK
authors.lastname: Miu
authors.affiliation: Department of Rehabilitation and Extended Care, Wong Tai Sin Hospital, Hong Kong.
authors.forename: Ching Wai
authors.initials: CW
authors.lastname: Chan
authors.affiliation: Department of Rehabilitation and Extended Care, Wong Tai Sin Hospital, Hong Kong.
authors.forename: Ching
authors.initials: C
authors.lastname: Kok
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003693:Delirium / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006723:Hong Kong; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D019467:Subacute Care; D013997:Time Factors; D016896:Treatment Outcome
keywords: delirium; delirium persistent; elderly; post-acute care