Delirium and correlates of delirium among newly admitted elderly patients: a cross-sectional study in a Saudi general hospital.

Abstract

BACKGROUNDDelirium is a common, often undiagnosed disorder in elderly patients, but no studies have been conducted in Saudi Arabia.OBJECTIVESTo determine the prevalence of delirium among elderly patients on admission and to identify associated factors.DESIGNA cross-sectional study.SETTINGTertiary care hospital, Saudi Arabia.PATIENTS AND METHODSElderly patients were evaluated for delirium within 24 hours of admission using the Confusion Assessment Method (CAM). The medical records were also reviewed to identify associated factors and whether the diagnosis of delirium was documented by the admitting physician.MAIN OUTCOME MEASURESPrevalence of delirium.RESULTSOf 147 patients aged 60 or over screened for delirium within 24 hours of admission, 32 (21.8%) patients were identified with delirium. Seven (21.9%) of the 32 patients with delirium had documentation of their diagnosis in the patient chart by the attending physician. Univariate logistic regression identified greater age (OR=2.70, 95%-CI: 1.21–6.02), higher unemployment rate (OR=3.30, 95%-CI: 1.43–7.61), more often had 3–5 co-morbidities (OR=2.69, 95%-CI: 1.14–6.33), and more cognitive impairment (OR=38.90, 95%-CI: 8.78–172.34) as risk factors for delirium on admission. Multivariate logistic regression analysis identified greater age (OR=2.53, 95%-CI: 1.08–5.88), higher unemployment rate (OR=3.73, 95%-CI: 1.52–9.13) and 3–5 co-morbidities (OR=3.31, 95%-CI: 1.30–8.46) as risk factors for delirium.CONCLUSIONSDelirium was common and frequently not recognized in elderly patients admitted to the hospital. Administration of the CAM was very helpful in identifying delirium at admission.LIMITATIONSThe main limitation of our study was the relatively small number of patients which might have limited the power to detect some associations.