Partial and no recovery from delirium after hospital discharge predict increased adverse events.
The implications of partial and no recovery from delirium after hospital discharge are not clear. We sought to explore whether partial and no recovery from delirium among recently discharged patients predicted increased adverse events (emergency room visits, hospitalisations, death) during the subsequent 3 months.



Prospective study of recovery from delirium in older hospital inpatients. The Confusion Assessment Method was used to diagnose delirium in hospital and determine recovery status after discharge (T0). Adverse events were determined during the 3 months T0. Survival analysis to the first adverse event and counting process modelling for one or more adverse events were used to examine associations between recovery status (ordinal variable, 0, 1 or 2 for full, partial or no recovery, respectively) and adverse events.



Of 278 hospital inpatients with delirium, 172 were discharged before the assessment of recovery status (T0). Delirium recovery status at T0 was determined for 152: 25 had full recovery, 32 had partial recovery and 95 had no recovery. Forty-four patients had at least one adverse event during the subsequent 3 months. In multivariable analysis of one or more adverse events, poorer recovery status predicted increased adverse events; the hazard ratio (HR) (95% confidence interval, CI) was 1.72 (1.09, 2.71). The association of recovery status with adverse events was stronger among patients without dementia.



Partial and no recovery from delirium after hospital discharge appear to predict increased adverse events during the subsequent 3 months These findings have potentially important implications for in-hospital and post-discharge management and policy.
St. Marys Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada.|Department of Psychiatry, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada
Martin G
MG
Cole
St. Marys Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada.|Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
Jane
J
McCusker
Division of Geriatric Medicine, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada.
Robert
R
Bailey
Division of Geriatric Medicine, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada.|Department of Medicine, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada
Michael
M
Bonnycastle
Division of Geriatric Medicine, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada.
Shek
S
Fung
St. Marys Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada.|Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
Antonio
A
Ciampi
St. Marys Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada.
Eric
E
Belzile
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003693:Delirium / Q000175:diagnosis / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D004636:Emergency Service, Hospital; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008603:Mental Health; D000073216:Mental Status and Dementia Tests; D015999:Multivariate Analysis; D010351:Patient Discharge; D010359:Patient Readmission; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors