Delirium, how does it end? Mortality as an outcome in older medical inpatients

Muresan, Maria-Laura; Adamis, Dimitrios; Murray, Orla; O’Mahony, Edmond; McCarthy, Geraldine

doi:10.1002/gps.4332

Cited by 8 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The only significant predictive factors for mortality were cognition as measured with the MoCA and severity of illness (APACHE-II). Regarding the association of mortality with delirium, this was not an unexpected finding as in previous work 30,31 we have found similar results. This may relate to (a) that we excluded terminally ill people, (b) we controlled for baseline cognition, and (c) issues with the small sample size.…”

Section: Discussionsupporting

confidence: 91%

Motor Disturbances in Elderly Medical Inpatients and Their Relationship to Delirium

Adamis

McCarthy

O’Mahony

et al. 2017

J Geriatr Psychiatry Neurol

Self Cite

View full text Add to dashboard Cite

Motor disturbances in delirious patients are common, but their relationship to cognition and severity of illness has not been studied. We examined motor subtypes in an older age inpatient population, their relationship to clinical variables including delirium, and their association with 1-year mortality in a prospective study, using the Confusion Assessment Method, Acute Physiology and Chronic Health Evaluation II, Montreal Cognitive Assessment (MoCA), Barthel Index, and Delirium Rating Scale-Revised 98 (DRS-R98). Motor subtypes were evaluated using 2 items of DRS-R98. Mortality rates were investigated 1 year later. Two hundred participated (mean age 81.1 [6.5]; 50% female). Thirty-four (17%) were identified with delirium. Motor subtypes were none: 119 (59.5%), hypoactive: 37 (18.5%), hyperactive: 29 (14.5%), and mixed: 15 (7.5%). Hypoactive and mixed subtypes were significantly more frequent in delirious patients. Regression analysis showed that hypoactive subtype was significantly associated with lower MoCA. No relationship between motor subtypes and mortality was found. Motor disturbances are not unique to delirium, with hypoactivity particularly associated with impaired cognition.

show abstract

Section: Discussionsupporting

confidence: 91%

Motor Disturbances in Elderly Medical Inpatients and Their Relationship to Delirium

Adamis

McCarthy

O’Mahony

et al. 2017

J Geriatr Psychiatry Neurol

Self Cite

View full text Add to dashboard Cite

show abstract

“…La edad avanzada es un factor constantemente asociado con delirium 2,20 , pero cuando se intenta esclarecer cómo se relacionan el delirium, la demencia y la mayor mortalidad, algunos estudios han encontrado que el delirium por sí solo es un factor independiente de riesgo de mayor mortalidad 24,25 , en tanto que otros reportan que el delirium no es un factor asociado con mayor mortalidad, como sí lo serían el deterioro cognitivo y la gravedad de la enfermedad [26][27][28][29] .…”

Section: Discussionunclassified

Factores de riesgo y mortalidad hospitalaria de los pacientes quirúrgicos y no quirúrgicos con delirium

Restrepo¹,

Duque²,

Montoya³

et al. 2018

Revista Colombiana de Psiquiatría

View full text Add to dashboard Cite

“…[4][5][6][7] Regardless of the risk factors leading to delirium in hospital treated elderly patients, the onset of the syndrome appears to result in increased length of hospital stay (LOS), as well as higher inhospital and early post-discharge mortality. 3,[8][9][10][11] However, several studies have found no association between delirium and hospital outcomes. 12,13 As with the rest of the world, the population of older people is increasing rapidly in Africa, with over 212 million people in the subregion projected to be 60 years or over by 2050.…”

Section: Introductionmentioning

confidence: 99%

“…The common risk factors of delirium in older medical in‐patients include age, sensory impairment, dementia, systemic infection, metabolic and endocrine syndromes, nutritional deficiencies, cardiovascular and respiratory disorders, alcohol and drug dependence 4–7 . Regardless of the risk factors leading to delirium in hospital treated elderly patients, the onset of the syndrome appears to result in increased length of hospital stay (LOS), as well as higher in‐hospital and early post‐discharge mortality 3,8–11 . However, several studies have found no association between delirium and hospital outcomes 12,13 …”

Section: Introductionmentioning

confidence: 99%

Risk factors and outcomes of delirium in hospitalized older Ghanaians

Omuojine

Bello

Wemakor

et al. 2023

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objectives Delirium has been rarely studied in older West Africans. We sought to investigate its correlates and outcomes in hospitalized older Ghanaians. Methods This was a one‐month prospective observational study. Delirium prevalence was assessed within 24 h of admission using the Confusion Assessment Method (CAM). Incident delirium was determined with repeat CAM assessments on post‐admission days 4, 7, 14, 21 and 28, after censoring participants with prevalent delirium. Multivariate logistic regression analyses were used to explore risk factors. Estimates of adjusted hazard ratios for mortality were derived with the discrete time version of the Cox regression model for time invariant explanatory variables. Results Among 483 participants, 250 (51.8%, 95% CI: 47.3–56.3) had prevalent delirium while 10 of the remaining 233 (4.3%, 95% CI: 2.1–7.8) developed incident delirium. Being older than 80 years (adjusted odds ratio (OR) = 2.1, 95% CI: 1.2–3.6), having no formal education (OR = 2.2, 95% CI: 1.4–3.4), stroke (OR = 1.8, 95% CI: 1.1–3.0), infection (OR = 1.9, 95% CI: 1.2–3.0), and high Triage Early Warning Score (OR = 6.9, 95% CI: 2.5–19.0) predicted delirium. Delirium (adjusted hazard ratio (HR) = 1.8, 95% CI: 1.0–3.3) and high TEWS (HR = 4.6 (95% CI: 1.7–12.7) at baseline predicted mortality. These factors also predicted longer hospital stay. Conclusion Over half of hospital‐treated older Ghanaians in the present study had delirium on the first day of admission. The syndrome prolonged hospitalisation and increased mortality risk. Future studies in West Africa may investigate the epidemiology of delirium in primary care and community settings.

show abstract

Delirium, how does it end? Mortality as an outcome in older medical inpatients

Cited by 8 publications

References 34 publications

Motor Disturbances in Elderly Medical Inpatients and Their Relationship to Delirium

Motor Disturbances in Elderly Medical Inpatients and Their Relationship to Delirium

Factores de riesgo y mortalidad hospitalaria de los pacientes quirúrgicos y no quirúrgicos con delirium

Risk factors and outcomes of delirium in hospitalized older Ghanaians

Contact Info

Product

Resources

About