Prospective, multi-centric benchmark study assessing delirium: prevalence, incidence and its correlates in hospitalized elderly Lebanese patients

Zrour, Carmen; Haddad, Raymond N.; Zoghbi, Marouan; Kharsa, Zahraa; Hijazi, Mariam; Naja, Wadih

doi:10.1007/s40520-019-01242-2

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…Findings revealed that a history of falls within three months before hospital admission heightened the risk of delirium. These results align with prior research [ 23 , 24 ]. A possible explanation may be that falls in older adults typically signal a decline in physical and cognitive function, as evidenced by impaired attention, executive function, and slowed gait [ 25 ].…”

Section: Discussionsupporting

confidence: 92%

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Effect of a fall within three months of admission on delirium in critically Ill elderly patients: a population-based cohort study

Bu,

Cheng,

Wang

et al. 2024

Aging Clin Exp Res

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Background Delirium is common among elderly patients in the intensive care unit (ICU) and is associated with prolonged hospitalization, increased healthcare costs, and increased risk of death. Understanding the potential risk factors and early prevention of delirium is critical to facilitate timely intervention that may reverse or mitigate the harmful consequences of delirium. Aim To clarify the effects of pre-admission falls on ICU outcomes, primarily delirium, and secondarily pressure injuries and urinary tract infections. Methods The study relied on data sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Statistical tests (Wilcoxon rank-sum or chi-squared) compared cohort characteristics. Logistic regression was employed to investigate the association between a history of falls and delirium, as well as secondary outcomes, while Kaplan–Meier survival curves were used to assess short-term survival in delirium and non-delirium patients. Results Study encompassed 22,547 participants. Delirium incidence was 40%, significantly higher in patients with a history of falls (54.4% vs. 34.5%, p < 0.001). Logistic regression, controlling for confounders, not only confirmed that a history of falls elevates the odds of delirium (OR: 2.11; 95% CI: 1.97–2.26; p < 0.001) but also showed it increases the incidence of urinary tract infections (OR:1.50; 95% CI:1.40–1.62; p < 0.001) and pressure injuries (OR:1.36; 95% CI:1.26–1.47; p < 0.001). Elderly delirium patients exhibited lower 30-, 180-, and 360-day survival rates than non-delirium counterparts (all p < 0.001). Conclusions The study reveals that history of falls significantly heighten the risk of delirium and other adverse outcomes in elderly ICU patients, leading to decreased short-term survival rates. This emphasizes the critical need for early interventions and could inform future strategies to manage and prevent these conditions in ICU settings.

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Section: Discussionsupporting

confidence: 92%

“…Findings revealed that a history of falls within three months before hospital admission heightened the risk of delirium. These results align with prior research [23,24].…”

Section: Discussionsupporting

confidence: 91%

Effect of a fall within three months of admission on delirium in critically Ill elderly patients: a population-based cohort study

Bu,

Cheng,

Wang

et al. 2024

Aging Clin Exp Res

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“…Delirium was measured by research personnel in 171 studies (54.3%), a combination of research personnel and physicians in 5 studies (1.6%), and a physician in 139 studies …”

Section: Resultsmentioning

confidence: 99%

Predisposing and Precipitating Factors Associated With Delirium

et al. 2023

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ImportanceDespite discrete etiologies leading to delirium, it is treated as a common end point in hospital and in clinical trials, and delirium research may be hampered by the attempt to treat all instances of delirium similarly, leaving delirium management as an unmet need. An individualized approach based on unique patterns of delirium pathophysiology, as reflected in predisposing factors and precipitants, may be necessary, but there exists no accepted method of grouping delirium into distinct etiologic subgroups.ObjectiveTo conduct a systematic review to identify potential predisposing and precipitating factors associated with delirium in adult patients agnostic to setting.Evidence ReviewA literature search was performed of PubMed, Embase, Web of Science, and PsycINFO from database inception to December 2021 using search Medical Subject Headings (MeSH) terms consciousness disorders, confusion, causality, and disease susceptibility, with constraints of cohort or case-control studies. Two reviewers selected studies that met the following criteria for inclusion: published in English, prospective cohort or case-control study, at least 50 participants, delirium assessment in person by a physician or trained research personnel using a reference standard, and results including a multivariable model to identify independent factors associated with delirium.FindingsA total of 315 studies were included with a mean (SD) Newcastle-Ottawa Scale score of 8.3 (0.8) out of 9. Across 101 144 patients (50 006 [50.0%] male and 49 766 [49.1%] female patients) represented (24 015 with delirium), studies reported 33 predisposing and 112 precipitating factors associated with delirium. There was a diversity of factors associated with delirium, with substantial physiological heterogeneity.Conclusions and RelevanceIn this systematic review, a comprehensive list of potential predisposing and precipitating factors associated with delirium was found across all clinical settings. These findings may be used to inform more precise study of delirium’s heterogeneous pathophysiology and treatment.

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“…Um estudo indicou que pacientes cirúrgicos ou críticos com idade entre 72 e 86 anos desenvolvem delirium durante a hospitalização. (17) A predisposição ao delirium parece aumentar com o envelhecimento, pois idosos hospitalizados têm maior probabilidade de desenvolver estados mentais confusionais. (18) No entanto, ambas as faixas etárias de nossa amostra foram caracterizadas por indivíduos de meia-idade, o que pode ser explicado pela causa da internação, associada principalmente a traumas e lesões neurovasculares.…”

Section: Discussionunclassified

Prevalência e fatores de risco associados ao delirium em uma unidade de terapia intensiva

Pinheiro¹,

Santana–Santos²,

Barreto³

et al. 2022

Acta Paulista De Enfermagem

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Prospective, multi-centric benchmark study assessing delirium: prevalence, incidence and its correlates in hospitalized elderly Lebanese patients

Cited by 5 publications

References 34 publications

Effect of a fall within three months of admission on delirium in critically Ill elderly patients: a population-based cohort study

Effect of a fall within three months of admission on delirium in critically Ill elderly patients: a population-based cohort study

Predisposing and Precipitating Factors Associated With Delirium

Prevalência e fatores de risco associados ao delirium em uma unidade de terapia intensiva

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