The Problem of Delirium in the Elderly

Wass, S. H.

doi:10.1007/978-981-10-3253-0_5

Cited by 8 publications

(11 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…Furthermore, delirium is linked to a higher rate of hospital-acquired complications, including infections, bed sores, and incontinence [ 2 , 15 , 30 ]. It is also associated with worse functional decline upon discharge and a higher rate of transfer to nursing homes [ 2 , 30 ]. Our study aligns with these findings, as patients with delirium showed a higher incidence of hospital-acquired infections, bed sores, and stress ulcers.…”

Section: Discussionmentioning

confidence: 99%

“…Delirium is highly prevalent among elderly patients admitted to various healthcare settings, with rates reaching up to 82% in mechanically ventilated patients in an ICU setting [ 1 ]. It is prevalent in ICU, palliative care, and post-hip-surgery patients [ 2 , 3 ]. A recent prospective study conducted in Oman revealed that delirium affects 55% of elderly patients admitted to medical wards, often going unrecognized by healthcare providers [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Also, delirium is associated with prolonged hospital stays, higher hospital-related complications, increased readmission rates [ 9 ], and worse functional and cognitive decline, along with dementia development [ 10 , 11 ]. In addition, delirium consequences affect patients and their families and increase healthcare costs [ 2 ]. All of this puts a significant burden on the patients, families, and healthcare system.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Delirium and Its Association with Short- and Long-Term Health Outcomes in Medically Admitted Patients: A Prospective Study

Al Huraizi,

Al-Maqbali,

Al Farsi

et al. 2023

JCM

View full text Add to dashboard Cite

Background: Delirium is highly prevalent among elderly hospitalized patients in various healthcare settings. This study aimed to assess the impact of delirium on short- and long-term health outcomes. Methods: A prospective cohort included medically ill patients (≥65 years) admitted to a tertiary healthcare facility. Delirium was screened using the 3-Minute Diagnostic confusion assessment method (3D-CAM). Results: During hospitalization, 53.8% (n = 153/284) had delirium. Patients with delirium had a longer length of hospital stay (LOS) (7 vs. 5 days; p < 0.01) compared to patients without delirium. Delirium caused a higher frequency of high-dependency unit (HDU) or intensive care unit (ICU) admission (p < 0.01) and an increased incidence of hospital-acquired complications, including infections (p = 0.03), pressure injuries (p = 0.01), and upper gastrointestinal bleeding (p < 0.01). Inpatient all-cause mortality was higher in patients with delirium than those without delirium (16.3% vs. 1.5%; p < 0.01). Patients with delirium had higher rates of 90-day all-cause mortality (25.4% vs. 8.4%; p < 0.01) and 1-year all-cause mortality (35.9% vs. 16%; p < 0.01) compared to patients without delirium. Patients with delirium exhibited shorter survival periods at 90 days and 1 year compared to patients without delirium with a hazard ratio (HR) = 3.41, 95% CI: 1.75–6.66, p < 0.01 and HR = 2.64, 95% CI: 1.59–4.37, p < 0.01, respectively. Conclusions: Delirium is associated with serious short-term and long-term clinical consequences. Early recognition, prevention, and targeted interventions addressing reversible risk factors are crucial. Further research is warranted to explore effective strategies for delirium management in general medical wards.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Delirium and Its Association with Short- and Long-Term Health Outcomes in Medically Admitted Patients: A Prospective Study

Al Huraizi,

Al-Maqbali,

Al Farsi

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…Estimations of incidence and prevalence of delirium vary a lot. On admission 18-35% (prevalence) of older hospitalized patients show symptoms of delirium and 11-29% (incidence) develop a delirium in the course of their hospital stay [2], whereas certain patient groups are more susceptible than others-especially patients with cancer, any terminal illness and patients after surgery are more vulnerable [3] As hospitalized geriatric patients frequently suffer from multimorbidity, delirium is multifactorial [4] Decades of research could already show a complex interaction between predisposing and precipitating factors [2]. Combined with precipitating factors predisposing factors are presumably triggering inflammatory processes and yielding to imbalances in neurotransmitter levels [5] As an early marker for inflammation or infection, laboratory parameters such as the C-reactive protein (CRP) and white blood cell count (WBC) levels are used [6].…”

Section: Introductionmentioning

confidence: 99%

Delirium in older hospitalized patients—A prospective analysis of the detailed course of delirium in geriatric inpatients

et al. 2023

View full text Add to dashboard Cite

Background Delirium in older hospitalized patients (> 65) is a common clinical syndrome, which is frequently unrecognized. Aims We aimed to describe the detailed clinical course of delirium and related cognitive functioning in geriatric patients in a mainly non-postoperative setting in association with demographic and clinical parameters and additionally to identify risk factors for delirium in this common setting. Methods Inpatients of a geriatric ward were screened for delirium and in the case of presence of delirium included into the study. Patients received three assessments including Mini-Mental-Status-Examination (MMSE) and the Delirium Rating Scale Revised 98 (DRS-R-98). We conducted correlation and linear mixed-effects model analyses to detect associations. Results Overall 31 patients (82 years (mean)) met the criteria for delirium and were included in the prospective observational study. Within one week of treatment, mean delirium symptom severity fell below the predefined cut-off. While overall cognitive functioning improved over time, short- and long-term memory deficits remained. Neuroradiological conspicuities were associated with cognitive deficits, but not with delirium severity. Discussion The temporal stability of some delirium symptoms (short-/long-term memory, language) on the one hand and on the other hand decrease in others (hallucinations, orientation) shown in our study visualizes the heterogeneity of symptoms attributed to delirium and their different courses, which complicates the differentiation between delirium and a preexisting cognitive decline. The recovery from delirium seems to be independent of preclinical cognitive status. Conclusion Treatment of the acute medical condition is associated with a fast decrease in delirium severity. Given the high incidence and prevalence of delirium in hospitalized older patients and its detrimental impact on cognition, abilities and personal independence further research needs to be done.

show abstract

Risk of bias in prognostic models of hospital-induced delirium for medical-surgical units: A systematic review

Snigurska,

Liu,

Ser

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Purpose The purpose of this systematic review was to assess risk of bias in existing prognostic models of hospital-induced delirium for medical-surgical units. Methods APA PsycInfo, CINAHL, MEDLINE, and Web of Science Core Collection were searched on July 8, 2022, to identify original studies which developed and validated prognostic models of hospital-induced delirium for adult patients who were hospitalized in medical-surgical units. The Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies was used for data extraction. The Prediction Model Risk of Bias Assessment Tool was used to assess risk of bias. Risk of bias was assessed across four domains: participants, predictors, outcome, and analysis. Results Thirteen studies were included in the qualitative synthesis, including ten model development and validation studies and three model validation only studies. The methods in all of the studies were rated to be at high overall risk of bias. The methods of statistical analysis were the greatest source of bias. External validity of models in the included studies was tested at low levels of transportability. Conclusions Our findings highlight the ongoing scientific challenge of developing a valid prognostic model of hospital-induced delirium for medical-surgical units to tailor preventive interventions to patients who are at high risk of this iatrogenic condition. With limited knowledge about generalizable prognosis of hospital-induced delirium in medical-surgical units, existing prognostic models should be used with caution when creating clinical practice policies. Future research protocols must include robust study designs which take into account the perspectives of clinicians to identify and validate risk factors of hospital-induced delirium for accurate and generalizable prognosis in medical-surgical units.

show abstract

The Problem of Delirium in the Elderly

Cited by 8 publications

References 90 publications

Delirium and Its Association with Short- and Long-Term Health Outcomes in Medically Admitted Patients: A Prospective Study

Delirium and Its Association with Short- and Long-Term Health Outcomes in Medically Admitted Patients: A Prospective Study

Delirium in older hospitalized patients—A prospective analysis of the detailed course of delirium in geriatric inpatients

Risk of bias in prognostic models of hospital-induced delirium for medical-surgical units: A systematic review

Contact Info

Product

Resources

About