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Incidence of delirium, risk factors, and long-term survival of elderly patients hospitalized in a medical specialty teaching hospital in Mexico City.
Int Psychogeriatr 2003; 15(4):325-36IP

Abstract

BACKGROUND

We determined the incidence, probable risk factors, causes, and long-term survival of delirium in patients hospitalized in a medical specialty teaching hospital in Mexico City.

METHOD

From June to December 1995, 667 elderly patients 60 years and older were hospitalized and assessed within 48 hours, excluding those with delirium at admission, those sedated, on respiratory support, or unable to speak.

RESULTS

Twelve percent of the population developed delirium, identified by means of the daily application of the Confusion Assessment Method; its appearance was attributed in 50% to two or more causes, in 10% to an insufficient control of pain, in 7.5% to a preceding surgical event, and in the rest to other causes. Each case was compared randomly with three nonpaired control patients of the same cohort who did not develop delirium. There was a significant increase in the number of cases of delirium in patients older than 75 years (p < .001), those with low schooling (p = .04), those with greater comorbidity (p < .001), those with a hematocrit lower than 30% (relative risk [RR] 2.1, confidence interval [CI] 1.2-4.1), and those with a glucose level greater than 140 mg/dl (RR 2.1, CI 1.2-3.6). Patients with delirium remained hospitalized longer than controls (p = .02). There was no significant difference in the intrahospital mortality of both groups, although during 5 years' follow-up, survivors demonstrated a significant increase in mortality (p = .03) in the group of individuals with delirium during the hospital stay when compared to controls.

CONCLUSION

In this geriatric population of Mexican patients, delirium incidence was similar to that previously reported in the worldwide literature. Its incidence is associated with longer hospital stay and greater mortality. Age, low level of schooling, greater comorbidity, high glucose levels, poor pain control, and hematocrit lower than 30% were independently associated with a greater incidence of delirium.

Authors+Show Affiliations

Geriatric Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15000413

Citation

Villalpando-Berumen, Juan Manuel, et al. "Incidence of Delirium, Risk Factors, and Long-term Survival of Elderly Patients Hospitalized in a Medical Specialty Teaching Hospital in Mexico City." International Psychogeriatrics, vol. 15, no. 4, 2003, pp. 325-36.
Villalpando-Berumen JM, Pineda-Colorado AM, Palacios P, et al. Incidence of delirium, risk factors, and long-term survival of elderly patients hospitalized in a medical specialty teaching hospital in Mexico City. Int Psychogeriatr. 2003;15(4):325-36.
Villalpando-Berumen, J. M., Pineda-Colorado, A. M., Palacios, P., Reyes-Guerrero, J., Villa, A. R., & Gutiérrez-Robledo, L. M. (2003). Incidence of delirium, risk factors, and long-term survival of elderly patients hospitalized in a medical specialty teaching hospital in Mexico City. International Psychogeriatrics, 15(4), pp. 325-36.
Villalpando-Berumen JM, et al. Incidence of Delirium, Risk Factors, and Long-term Survival of Elderly Patients Hospitalized in a Medical Specialty Teaching Hospital in Mexico City. Int Psychogeriatr. 2003;15(4):325-36. PubMed PMID: 15000413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of delirium, risk factors, and long-term survival of elderly patients hospitalized in a medical specialty teaching hospital in Mexico City. AU - Villalpando-Berumen,Juan Manuel, AU - Pineda-Colorado,Ana Margarita, AU - Palacios,Perla, AU - Reyes-Guerrero,Jorge, AU - Villa,Antonio R, AU - Gutiérrez-Robledo,Luis Miguel, PY - 2004/3/6/pubmed PY - 2004/8/11/medline PY - 2004/3/6/entrez SP - 325 EP - 36 JF - International psychogeriatrics JO - Int Psychogeriatr VL - 15 IS - 4 N2 - BACKGROUND: We determined the incidence, probable risk factors, causes, and long-term survival of delirium in patients hospitalized in a medical specialty teaching hospital in Mexico City. METHOD: From June to December 1995, 667 elderly patients 60 years and older were hospitalized and assessed within 48 hours, excluding those with delirium at admission, those sedated, on respiratory support, or unable to speak. RESULTS: Twelve percent of the population developed delirium, identified by means of the daily application of the Confusion Assessment Method; its appearance was attributed in 50% to two or more causes, in 10% to an insufficient control of pain, in 7.5% to a preceding surgical event, and in the rest to other causes. Each case was compared randomly with three nonpaired control patients of the same cohort who did not develop delirium. There was a significant increase in the number of cases of delirium in patients older than 75 years (p < .001), those with low schooling (p = .04), those with greater comorbidity (p < .001), those with a hematocrit lower than 30% (relative risk [RR] 2.1, confidence interval [CI] 1.2-4.1), and those with a glucose level greater than 140 mg/dl (RR 2.1, CI 1.2-3.6). Patients with delirium remained hospitalized longer than controls (p = .02). There was no significant difference in the intrahospital mortality of both groups, although during 5 years' follow-up, survivors demonstrated a significant increase in mortality (p = .03) in the group of individuals with delirium during the hospital stay when compared to controls. CONCLUSION: In this geriatric population of Mexican patients, delirium incidence was similar to that previously reported in the worldwide literature. Its incidence is associated with longer hospital stay and greater mortality. Age, low level of schooling, greater comorbidity, high glucose levels, poor pain control, and hematocrit lower than 30% were independently associated with a greater incidence of delirium. SN - 1041-6102 UR - https://www.unboundmedicine.com/medline/citation/15000413/Incidence_of_delirium_risk_factors_and_long_term_survival_of_elderly_patients_hospitalized_in_a_medical_specialty_teaching_hospital_in_Mexico_City_ L2 - https://medlineplus.gov/delirium.html DB - PRIME DP - Unbound Medicine ER -