Abstract
BackgroundDelirium is a neuropsychiatric syndrome frequently observed in elderly hospitalised patients and can be found in any medical condition. Due to the severe consequences, early recognition of delirium is important in order to start treatment in time. Despite the high incidence rate, the occurrence of delirium is not always identified as such. Knowledge of potential risk factors is important. The aim of the current study is to determine factors associated with the occurrence of a prevalent delirium among elderly patients acutely admitted to an internal medicine ward.MethodsAll consecutive patients of 65 years and over acutely admitted to the Department of Internal Medicine of the Academic Medical Centre, Amsterdam, a university hospital, were asked to participate. The presence of delirium was determined within 48 hrs after admission by an experienced geriatrician.ResultsIn total, 126 patients were included, 29% had a prevalent delirium after acute admission. Compared to patients without delirium, patients with delirium were older, more often were cognitively and physically impaired, more often were admitted due to water and electrolyte disturbances, and were less often admitted due to malignancy or gastrointestinal bleeding. Independent risk factors for having a prevalent delirium after acute admission were premorbid cognitive impairment, functional impairment, an elevated urea nitrogen level, and the number of leucocytes.ConclusionsIn this study, the most important independent risk factors for a prevalent delirium after acute admission were cognitive and physical impairment, and a high serum urea nitrogen concentration. These observations might contribute to an earlier identification and treatment of delirium in acutely admitted elderly patients.
Highlights
Delirium is a neuropsychiatric syndrome frequently observed in elderly hospitalised patients and can be found in any medical condition
Delirium is often believed to present with agitation, hallucination, and inappropriate behaviour, whereas it often presents with lethargy and decreased activity
The aim of the current study is to determine factors associated with a prevalent delirium among acutely admitted elderly patients to an internal medicine ward
Summary
Delirium is a neuropsychiatric syndrome frequently observed in elderly hospitalised patients and can be found in any medical condition. Delirium can be found in any medical condition and is the most common reason for acute cognitive dysfunction in hospitalised elderly patients [1,2,3]. This syndrome occurs in about 10 to 25% of all acute admissions to a general hospital. Delirium has been associated with a poor outcome: prolonged hospitalisation, decreased cognitive and physical functioning, increased nursing home admission, and with a threefold higher morbidity and mortality risk [5,6]. The fluctuating course of the delirium may confound the diagnosis [9]
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