Evaluation of delirium in aged patients assisted at emergency hospital service

Ohl, Isabella Cristina Barduchi; Chavaglia, Suzel Regina Ribeiro; Ohl, Rosali Isabel Barduchi; Lopes, Maria Carolina Barbosa Teixeira; Campanharo, Cássia Regina Vancini; Okuno, Meiry Fernanda Pinto; Batista, Ruth Ester Assayag

doi:10.1590/0034-7167-2018-0386

Cited by 9 publications

(6 citation statements)

References 24 publications

(41 reference statements)

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“…The results presented in this study demonstrate that the prevalence of delirium at ER is high (n = 98, 13.41%), in line with that indicated in other Brazilian screening studies conducted in the same environment (13)(14) . The results also match the findings of research carried out in the emergency services of other countries and a meta-analysis (7,(15)(16) .…”

Section: Discussionsupporting

confidence: 91%

“…Several studies show that the disorder is age-dependent, that is, the older the age, the higher the chance of diagnosis, converging with the results presented here (OR: 1.05; CI (95%): 1.02-1.08) (17)(18)(19) . The sample was characterized, in its majority, by male individuals (n = 394, 53.90%), something common in research in the hospital environment, given the culture that discourages men to care for their health (14,20) .…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the reason for hospitalization and its relation to delirium, the specificity in the sample studied of diseases of the circulatory system is clear. Hypertension and diabetes mellitus are among the principal diseases that affect the elderly population in Brazil, causing significant limitations in the quality of life and increased mortality, which contributes to the development of cognitive impairments such as delirium (14,20) .…”

Section: Discussionmentioning

confidence: 99%

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Delirium in the elderly admitted to an emergency hospital service

et al. 2022

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Objective: To check for the presence of delirium in the elderly entering the emergency room (ER) of the University Hospital of Santa Maria (HUSM) and their relationship with sociodemographic variables, reason and time of hospitalization, comorbidities, and death. Methods: A quantitative, cross-sectional exploratory study, which analyzed data from the sociodemographic profile, Confusion Assessment Method, Charlson Comorbidities Index, and follow-up of the outcomes “in-hospital death” and “length of hospitalization.” The period analyzed in the study was between July and December 2019. Results: Of the 732 participants, 394 (53.90%) were men, with an average age of 72 years. The study identified Delirium in 99 (13.52%) participants, and death, in 120 (16.39%). There was an association of this disorder with age, comorbidities, length of hospitalization, death, and some reasons for hospitalization, such as diseases of the circulatory, respiratory and genitourinary systems. Conclusion: The results warn of the high incidence of delirium in emergency units and their relationship with a worse prognosis.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Delirium in the elderly admitted to an emergency hospital service

et al. 2022

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“…Delirium, aka acute confusional syndrome (ACS), is a neurocognitive disorder of complex aetiology often under‐diagnosed that affects the cognitive functionality of the subject (Setters & Solberg, 2017). It is the second more prevalent psychiatric syndrome in the hospital environment (Ohl et al, 2019). Precursors of delirium are anxiety, changes in the sleep cycles and acute changes in attention and consciousness.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for prediction of delirium at hospital admittance

et al. 2021

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Aging population in many developed countries, moves the issue of healthy aging at the forefront of the political, scientific and technological concerns. Delirium is a multifactorial disorder that is highly prevalent in hospitalized elderly people that causes complications in the patient care and increases mortality at the hospital and soon after discharge. Early diagnostics would allow improved treatment and prevention for a syndrome that requires very personalized treatment. This paper deals with machine learning based prediction of delirium at hospital admittance as a computer aided diagnostic tool, as well as with the identification of risk factors by means of the variable importance computed by the classifier model building approaches. We achieve almost 0.80 classification accuracy, which is encourages further exploration of improved classifier models. Exploration of variable importance shows that frailty, dementia and some pharmacological factors are relevant risk factors for delirium at hospital admittance.

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“…Delirium prevalence is highly variable depending on the study, population, and environmental conditions [ 24 , 25 , 26 ]. Delirium is the second most prevalent psychiatric syndrome in the hospital environment [ 27 ]. In the older population, delirium carries higher mortality risks, longer hospital stays, and impedes cognitive and functional capabilities [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Survival of Frail Elderly with Delirium

Cano‐Escalera

Graña

Irazusta

et al. 2022

IJERPH

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This study aims to determine when frailty increases the risks of delirium mortality. Hospital patients falling into the elderly frail or pre-frail category were recruited, some without delirium, some with delirium at admission, and some who developed delirium during admission. We screened for frailty, cognitive status, and co-morbidities whenever possible and extracted drug information and mortality data from electronic health records. Kaplan–Meier estimates of survival probability functions were computed at four times, comparing delirium versus non delirium patients. Differences in survival were assessed by a log-rank test. Independent Cox’s regression was carried out to identify significant hazard risks (HR) at 1 month, 6 months, 1 year, and 2 years. Delirium predicted mortality (log-rank test, p < 0.0001) at all four censoring points. Variables with significant HRs were frailty indicators, comorbidities, polypharmacy, and the use of specific drugs. For the delirium cohort, variables with the most significant 2-year hazard risks (HR(95%CI)) were: male gender (0.43 20 (0.26,0.69)), weight loss (0.45 (0.26,0.74)), sit and stand up test (0.67 (0.49,0.92)), readmission within 30 days of discharge (0.50 (0.30,0.80)), cerebrovascular disease (0.45 (0.27,0.76)), head trauma (0.54 22 (0.29,0.98)), number of prescribed drugs (1.10 (1.03,1.18)), and the use of diuretics (0.57 (0.34,0.96)). These results suggest that polypharmacy and the use of diuretics increase mortality in frail elderly patients with delirium.

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Evaluation of delirium in aged patients assisted at emergency hospital service

Cited by 9 publications

References 24 publications

Delirium in the elderly admitted to an emergency hospital service

Delirium in the elderly admitted to an emergency hospital service

Risk factors for prediction of delirium at hospital admittance

Survival of Frail Elderly with Delirium

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