219 Delirium snapshot—inpatient rates and demographics of delirium in an Irish university teaching hospital

Abstract

Abstract Background Delirium has been repeatedly demonstrated to increase morbidity and mortality both in the inpatient setting and post-discharge. This study sets out to examine the rates and demographics of delirium in the inpatient setting and identify significant risk factors for its development. Methods Data was collected on inpatients on a single day (13/12/22) using an internet application developed by the Hospital’s Quality and Improvement Department. Biographical data, length of stay (LOS), source of admission, admission diagnosis, clinical diagnosis of delirium and/or dementia and preadmission and current continence data were gathered from medical or nursing notes. Data was analysed and statistical significance determined via Pearson’s Chi-Squared Test. Results Data was available for 309 inpatients. The point prevalence of delirium was 25.2% (78/309). About half of delirious patients were female (41/78) and (38/78) had a previous diagnosis of dementia (p = <0.01). Almost a quarter of the cohort had pre-existing cognitive impairment (73/309, 23.6%). Nursing home residents had the highest percentage of delirium 17/42 (40.5%) by admission source (p = 0.01). Delirium prevalence increased with age reaching 37.5% in those over 90 years, (p = 0.03). Delirium was more prevalent in those with a longer LOS (19.8% LOS <7 days compared to 44.6% LOS >7 days). Delirium rates were higher in those incontinent or catheterized both at baseline and during admission (p = <0.01), as well as in those requiring assistance with mobility (p = <0.01). Conclusion Approximately a quarter of all inpatients experienced delirium during their admission. However, these figures were significantly higher in at risk categories such as those aged ≥70, Nursing Home residents and those with cognitive impairment. Despite extensive awareness and education of the risks of delirium, its prevalence remains too high. Further interventions are urgently needed.