Delirium in Australian Hospitals: A Prospective Study

Abstract

Objectives. Australian data regarding delirium in older hospitalized patients are limited. Hence, this study aimed to determine the prevalence and incidence of delirium among older patients admitted to Australian hospitals and assess associated outcomes. Method. A prospective observational study (n = 493) of patients aged ≥70 years admitted to four Australian hospitals was undertaken. Trained research nurses completed comprehensive geriatric assessments using standardized instruments including the Confusion Assessment Method to assess for delirium. Nurses also visited the wards daily to assess for incident delirium and other adverse outcomes. Diagnoses of dementia and delirium were established through case reviews by independent physicians. Results. Overall, 9.7% of patients had delirium at admission and a further 7.6% developed delirium during the hospital stay. Dementia was the most important predictor of delirium at (OR = 3.18, 95% CI: 1.65–6.14) and during the admission (OR = 4.82; 95% CI: 2.19–10.62). Delirium at and during the admission predicted increased in-hospital mortality (OR = 5.19, 95% CI: 1.27–21.24; OR = 31.07, 95% CI: 9.30–103.78). Conclusion. These Australian data confirm that delirium is a common and serious condition among older hospital patients. Hospital clinicians should maintain a high index of suspicion for delirium in older patients.

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“…In the hospitalised elderly, the reported incidence of delirium may be as high as 50% (Inouye et al, ). Delirium superimposed on dementia is particularly prevalent (Travers et al, ; Wand et al, ; Fong et al, ). A recent review reported that dementia was a significant risk factor for delirium in hospitalised elderly patients; the presence of dementia at baseline consistently increased the risk of delirium between two to five times, with delirium rates between 9 and 44% (Fong et al, ).…”

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“…Delirium is a serious medical condition with a prevalence of approximately 15% among hospitalized older adults . It is more common in the critically ill and in those undergoing major surgery, such as cardiac surgery, where estimates of prevalence can reach up to 42% …”

“…D elirium is a serious medical condition with a prevalence of approximately 15% among hospitalized older adults. 1 It is more common in the critically ill and in those undergoing major surgery, such as cardiac surgery, where estimates of prevalence can reach up to 42%. [2][3][4][5] Current approaches to the prevention of delirium in hospitalized patients include both nonpharmacologic and pharmacologic approaches.…”