Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study

Sidoli, Chiara; Zambon, Antonella; Tassistro, Elena; Rossi, Emanuela; Mossello, Enrico; Inzitari, Marco; Cherubini, Antonio; Marengoni, Alessandra; Morandi, Alessandro; Bellelli, Giuseppe

doi:10.1007/s40520-022-02099-8

Cited by 3 publications

(4 citation statements)

References 45 publications

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“…Regarding delirium subtypes, studies differ on their prevalence in geriatric rehabilitation facilities. However, the hypoactive 11,12 and the mixed one seem to be more prevalent 13 . Even though all these data might suggest that the environment of a post-acute care facility influences delirium persistence, it is unclear and more research is required.…”

Section: Peculiarities Of Delirium Features In Geriatric Rehabmentioning

confidence: 90%

“…Among the 21 studies reviewed, 19 used screening tools to identify delirium in intermediate care settings. As shown in Figure 1, most papers used the Confusion Assessment Method (CAM) or a CAM-based screening instrument (n = 13, 68%) 8,9,11,14,15,[20][21][22]2529 , whereas 3 articles used the 4ATest (4AT) (16%) 12,13,30 , and 2 articles used the Delirium Rating Scale Revised-98 (DRS-98) (11%) 4,7 . The Memorial Delirium Assessment Scale (MDAS) and the Delirium Diagnostic Tool-provisional (DDT-Pro) were only used in one study each 24,30 .…”

Section: The Challenge Of Diagnosing Delirium In Geriatric Rehabmentioning

confidence: 99%

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Delirium in geriatric rehabilitation: the continued case of B.M

Gual

Nicolas

Inzitari

2023

JGG

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Section: Peculiarities Of Delirium Features In Geriatric Rehabmentioning

confidence: 90%

Section: The Challenge Of Diagnosing Delirium In Geriatric Rehabmentioning

confidence: 99%

Delirium in geriatric rehabilitation: the continued case of B.M

Gual

Nicolas

Inzitari

2023

JGG

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“…Physical disability has been widely associated as a risk factor for the onset of delirium; an example of this is the study by Sidoli et al [39] in which 1237 patients aged 65 years or older were studied and it was found that non-modifiable factors, such as physical disability, and modifiable factors, such as physical restrictions, were associated with the onset of delirium.…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional, Retrospective, and Comparative Study between Delirium and Non-Delirium Psychiatric Disorders in a Psychogeriatric Inpatient Population Referred to Consultation-Liaison Psychiatry Unit

et al. 2023

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Background and objectives: Delirium is the most prevalent psychiatric disorder in inpatient older people. Its presence is associated with higher rates of institutionalization, functional disability and mortality. This study aims to evaluate delirium in a hospitalized psychogeriatric population, focusing on which factors predict the appearance of delirium, the impact it generates and the diagnostic concordance between non-psychiatric physicians and psychiatrists. Material and methods: This is an observational, cross-sectional, retrospective, and comparative study. We obtained data from a sample of 1017 patients (≥65 years) admitted to general hospital and referred from different services to the consultation-liaison psychiatry (CLP) unit. Logistic regression was performed using delirium as the dependent variable. To estimate the concordance of the diagnoses, the Kappa coefficient was used. To assess the impact of delirium, an ordinal regression, Wilcoxon median test and Fisher’s test were performed. Results: Delirium is associated with a higher number of visits, OR 3.04 (95% CI 2.38–3.88), longer length of stay and mortality, OR 2.07 (95% CI, 1.05 to 4.10). The model to predict delirium shows that being >75 years old has an OR of 2.1 (95% CI, 1.59–2.79), physical disability has an OR of 1.66 (95% CI, 1.25–2.20), history of delirium has an OR of 10.56 (95% CI, 5.26–21.18) and no use of benzodiazepines has an OR of 4.24 (95% CI, 2.92–6.14). The concordance between the referring physician’s psychiatric diagnosis and the psychiatrist CLP unit showed a kappa of 0.30. When analysing depression and delirium, the concordance showed Kappa = 0.46. Conclusions: Delirium is a highly prevalent psychiatric disorder, but it is still underdiagnosed, with low diagnostic concordance between non-psychiatric doctors and psychiatrists from CLP units. There are multiple risk factors associated with the appearance of delirium, which must be managed to reduce its appearance.

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“…Delirium is a serious acute neuropsychiatric syndrome, characterized by acute and fluctuating inattention, other cognitive deficits, and alterations in level of consciousness, that is independently associated with several adverse outcomes 1 . Previous studies, carried out in Europe and in Italy [2][3][4][5][6][7] , found a prevalence of around 20-23% in hospital wards and of 18% and above 30% across rehabilitation settings and nursing home cares, respectively. Delirium is therefore a transdisciplinary condition that can affect vulnerable people across all settings of care.…”

Section: Introductionmentioning

confidence: 96%