Comparison of hospital course and outcome in hospital-acquired vs pre-existing delirium

Guillory, Joseph; Fitz-Gerald, Cecilia; Banik, Antara; Sterwald, Christopher; Ashiofu, Evelyn; Knox, Eleanore; Muyco, Mary Antoinette; Verlage, Megan; Abdali, Arqam; O'Malley, Patrick W; Rezai, Amelia; Bush, Paul W.; Brown, E. Sherwood; North, Carol S.

doi:10.12788/acp.0021

Cited by 4 publications

(2 citation statements)

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“…While it is unknown whether the pathophysiology of hospital acquired or incident delirium differs from delirium already prevalent on admission, incident delirium as studied here is associated with longer length of stay. 68,69 the baseline cognitive status of some patients, and home medications. However, most of the medications identified are not common outpatient medications.…”

Section: Discussionmentioning

confidence: 99%

Associations between early in-hospital medications and the development of delirium in patients with stroke

Ryan¹,

Liu²,

McKenna³

et al. 2023

Journal of Stroke and Cerebrovascular Diseases

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Section: Discussionmentioning

confidence: 99%

Associations between early in-hospital medications and the development of delirium in patients with stroke

Ryan¹,

Liu²,

McKenna³

et al. 2023

Journal of Stroke and Cerebrovascular Diseases

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“…While it is unknown whether the pathophysiology of hospital acquired or incident delirium differs from delirium already prevalent on admission, incident delirium as studied here is associated with longer length of stay. 68,69 Given the retrospective nature of the study, some covariate data was missing, for example knowledge of the baseline cognitive status of some patients, and home medications. However, most of the medications identified are not common outpatient medications.…”

Section: Discussionmentioning

confidence: 99%

Associations between early in-hospital medications and the development of delirium in patients with stroke

Ryan

Liu

McKenna

et al. 2023

Preprint

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ObjectivesPatients hospitalized with stroke develop delirium at higher rates than general hospitalized patients. While several medications are associated with existing delirium, it is unknown whether early medication exposures are associated with subsequent delirium in patients with stroke. Additionally, it is unknown whether delirium identification is associated with changes in the prescription of these medications.Materials and MethodsWe conducted a retrospective cohort study of patients admitted to a comprehensive stroke center, who were assessed for delirium by trained nursing staff during clinical care. We analyzed exposures to multiple medication classes in the first 48 hours of admission, and compared them between patients who developed delirium >48 hours after admission and those who never developed delirium. Statistical analysis was performed using univariate testing and multivariable logistic regression.Results1,710 unique patients were included in the cohort, of whom 471 (27.5%) developed delirium >48 hours after admission. Delirium was associated with prior exposure to antipsychotics, sedatives, opiates, and antimicrobials, even after accounting for several clinical covariates. Usage of these medications decreased in the 48 hours following delirium identification, except for atypical antipsychotics, whose use increased. Other medication classes such as steroids, benzodiazepines, and sleep aids were not initially associated with subsequent delirium, but prescription patterns still changed after delirium identification.ConclusionsEarly exposure to multiple medication classes is associated with the subsequent development of delirium in patients with stroke. Additionally, prescription patterns changed following delirium identification, suggesting that these medication classes may be modifiable targets for future delirium prevention strategies.140-character messageEarly exposure to specific medication classes is associated with delirium in patients with stroke & may be targets for future prevention.@SophiaLRyan, @ekimchi, @MGHNeurology, @MSHSNeurology, @NMNeurology

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A Novel Research Rotation for Residents Based on Serial Group Projects Using Existing Data Sets

et al. 2022

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Comparison of hospital course and outcome in hospital-acquired vs pre-existing delirium

Cited by 4 publications

References 0 publications

Associations between early in-hospital medications and the development of delirium in patients with stroke

Associations between early in-hospital medications and the development of delirium in patients with stroke

Associations between early in-hospital medications and the development of delirium in patients with stroke

A Novel Research Rotation for Residents Based on Serial Group Projects Using Existing Data Sets

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