Risk factors for delirium and inpatient mortality with delirium

Grover, Sandeep; Ghormode, Deepak; Ghosh, Abhishek; Chakrabarti, Subho; Mattoo, Surendra Kumar; Malhotra, Savita

doi:10.4103/0022-3859.123147

Cited by 26 publications

(34 citation statements)

References 29 publications

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“…Delirium is a critical mental status and a significant predictor of mortality. 39 Therefore, high mortality rates within the first month following antipsychotic prescription, particularly in the haloperidol group, can be attributed to the preexisting physical morbidities rather than the toxicity or adverse effects of the prescribed medications in the patients. In this study, a nonsignificant difference in the mortality risk was observed between the haloperidol and chlorpromazine groups at 90 days following prescription, indicating that if patients prescribed antipsychotic medications in urgent situations (ie, short-term and midterm uses) are excluded, the mortality risk of the haloperidol group was not particularly high.…”

Section: Discussionmentioning

confidence: 99%

Risk of Mortality Among Patients Treated With Antipsychotic Medications

Wang

Lee

Yuan

et al. 2016

Journal of Clinical Psychopharmacology

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In this nationwide population-based study, we examined whether haloperidol exposure is associated with a higher risk of mortality than are other antipsychotic medications. Patients who newly received monotherapy with chlorpromazine (n = 2133), haloperidol (n = 4454), quetiapine (n = 1513), and risperidone (n = 1046) between January 1, 2001, and December 31, 2011, were selected from a random sample of the 1 million enrollees of the Taiwan National Health Insurance Research Database. The association between antipsychotic prescription and mortality was estimated through Cox proportional hazard regression. To examine the mortality rates of antipsychotics at different exposure durations, we compared the differences among short-term (≤30 days), midterm (31-90 days), and long-term (>90 days) antipsychotic use. The mortality rates during the follow-up among the chlorpromazine, haloperidol, quetiapine, and risperidone groups were 17.4%, 45.5%, 26.8%, and 25.9%, respectively. The mortality risk among patients receiving haloperidol was the highest within 30 days of the prescription, after which the risk reduced rapidly. Compared with the patients receiving chlorpromazine, the mortality risk was higher in short-term (adjusted hazard ratio, 2.11; 95% confidence interval, 1.87-2.39) and midterm haloperidol users (1.86; 1.54-2.25) than in long-term users (0.99; 0.61-1.61). In conclusion, haloperidol use is associated with higher mortality risk than other antipsychotic medications. The mortality risk varies according to the duration of drug exposure. Underlying characteristics and medical conditions may influence the estimation of the mortality risk. Clinicians should pay attention to the mortality risk when prescribing antipsychotic medications, particularly for the elderly and critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Risk of Mortality Among Patients Treated With Antipsychotic Medications

Wang

Lee

Yuan

et al. 2016

Journal of Clinical Psychopharmacology

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“…This form aims to evaluate the risk factors related to delirium in patients and was prepared by the researcher based on the review of the respective literature and includes mostly the evidence‐level results (Barr et al., ; Celis‐ Rodriguez et al., ; van Diapen et al., ; Grover et al., ; Guenther et al., ; McPherson et al., ; Öztürk Birge & Tel Aydın, ; Pauley et al., ; Sato et al., ; Zhu et al., ). The delirium‐related risk factors evaluated in the form include any hearing and visual problems, the presence of invasive procedures such as central venous catheter, bladder catheter and NG/TPN, history of smoking and alcohol usage, the presence of hypoxia (SPO 2 < 90), hypo/hyperglycaemia (<70 or >200 mg/dl), hypo/hypernatremia (<135 or >145 mEq/L), hypo/hyperthermia (<36 or >38°C), Blood–Urea–Nitrogen/Creatinine (BUN/Cre) ≥18, anaemia (Hgb < 12 g/dl), hypoalbuminemia (Alb < 3.5 g/dl) and C‐reactive protein (CRP) >5 mg/dl.…”

Section: Methodsmentioning

confidence: 99%

The relationship of delirium and risk factors for cardiology intensive care unit patients with the nursing workload

Birge

Bedük

2018

Journal of Clinical Nursing

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“…With regard to restraint use, van der Kooi et al (2015) reported that one of the reasons for physical restraint use in the ICU of Dutch hospital was delirium. Grover et al (2013) supported this fmding and further reported that physical restraint was a significant predictor of mortality for patients 65 years and older.…”

Section: Difficulty In Identification and Current Managementsupporting

confidence: 58%

The Effect of Music Intervention on CAM Scores of Hospitalized Older Adults Experiencing Delirium

Dizon

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Older adults are vulnerable to developing while hospitalized is delirium.Research has shown that non-pharmacological interventions are effective in managing delirium and should be the first-line of treatment; however despite this, nurses fmd it difficult to address delirium. The purpose of this research study is to examine the effectiveness of classical music intervention in hospitalized older adults experiencing delirium by evaluating their Confusion Assessment Method (CAM) scores.A pre-and-post study design to compare the CAM scores of patients before and after music intervention was implemented. Study participants were patients 65 years and older identified to be experiencing delirium by a CAM score of greater than 6 admitted to a medical unit of a community hospital. In a sample of 8 study participants, the paired ttest revealed the post-CAM score after music was played showed an average of0.3 points lower than the pre-CAM (p = .39). Though the results of the study did not show a statistically significant difference, the study's participants' responses suggest that music, as an adjunct intervention, could aid in the management of delirium. These fmdings indicate the need to for further research in examining the relationship between music and delirium.

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Risk factors for delirium and inpatient mortality with delirium

Abstract: Age and use of restraints appears to be an important predictor mortality in patients with delirium.

Cited by 26 publications

References 29 publications

Risk of Mortality Among Patients Treated With Antipsychotic Medications

Risk of Mortality Among Patients Treated With Antipsychotic Medications

The relationship of delirium and risk factors for cardiology intensive care unit patients with the nursing workload

The Effect of Music Intervention on CAM Scores of Hospitalized Older Adults Experiencing Delirium

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