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

Abstract

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.

Frailty in an Adult Acute Hospital Population: Predictors, Prevalence, and Outcomes

“…Other factors associated with adverse outcomes in this study included delirium, which was independently associated with inpatient mortality, and cognitive impairment, which was itself associated with nursing home admission at one year. Delirium has been established as a risk factor for increased inpatient mortality [ 49 ], particularly among critically unwell older adults [ 50 ]. Cognitive decline among inpatients is well established as increasing the risk of admission to long-term nursing care from acute hospital care [ 51 ].…”

In-Hospital Delirium and Disability and Cognitive Impairment After COVID-19 Hospitalization

“…Delirium is a potent risk factor for hospital-related complications, including longer hospitalizations, unplanned ICU admission, discharge to a nursing facility, and all-cause mortality. 6 , 7 , 8 It has long-term adverse sequelae and has been associated with persistent cognitive decline and institutionalization. 9 , 10 , 11 The COVID-19 pandemic amplified certain factors associated with increased risk of delirium.…”