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Geriatric ward hospitalization reduced incidence delirium among older medical inpatients.
Am J Geriatr Psychiatry 2009; 17(9):760-8AJ

Abstract

OBJECTIVES

Most strategies for delirium prevention in older hospitalized patients are common good clinical geriatric care. We investigated whether acute geriatric ward (AGW) hospitalization, compared with acute general medical ward (AGMW) hospitalization,is associated with reduced incident delirium in older medical inpatients.

DESIGN

prospective observational study.

SETTING

a tertiary care, university hospital in Torino.

PARTICIPANTS

consecutive medical patients 70 years or older admitted from the emergency department to an AGW and to an AGMW were included.

MEASUREMENTS

Baseline measures included demography, functional and psychocognitive status, comorbidity, physiological and clinical severity of acute illness. Incident delirium was evaluated by qualified psychiatrists according to the Confusion Assessment Method and the Delirium Rating Scale.

RESULTS

Delirium occurred in 8 of 121 patients admitted to AGW (6.6%) and in 20 of 131 patients admitted to AGMW (15.2%). After adjustment for significant differences in baseline covariates between groups, AGW hospitalization remained independently associated with less incident delirium (relative risk 0.90, 95% confidence interval: 0.024-0.331, p <0.001). In a multivariable logistic model with delirium incidence as independent variable, AGW hospitalization was independently associated with lower delirium incidence (relative risk 0.039, 95% confidence interval: 0.007-0.214, p <0.001), whereas greater cognitive impairment (p <0.001), higher Acute Physiology and Chronic Health Evaluation II score (p 0.001) and recent stressful events (p <0.001) were associated with increased delirium incidence.

CONCLUSION

AGW hospitalization is associated with less incident delirium among older medical inpatients. Despite inherent limitations of observational studies, these hypothesis-generating findings add to previous evidence of potential benefit in delirium prevention from geriatric consultation in several hospital settings.

Authors+Show Affiliations

SCDU Geriatria, Dipartimento Discipline Medico Chirurgiche, Azienda Ospedaliera Universitaria San Giovanni Battista-Molinette-C.so Bramante 88, 10126, Torino, Italia.No affiliation info availableNo affiliation info availableNo 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

19705520

Citation

Bo, Mario, et al. "Geriatric Ward Hospitalization Reduced Incidence Delirium Among Older Medical Inpatients." The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, vol. 17, no. 9, 2009, pp. 760-8.
Bo M, Martini B, Ruatta C, et al. Geriatric ward hospitalization reduced incidence delirium among older medical inpatients. Am J Geriatr Psychiatry. 2009;17(9):760-8.
Bo, M., Martini, B., Ruatta, C., Massaia, M., Ricauda, N. A., Varetto, A., ... Torta, R. (2009). Geriatric ward hospitalization reduced incidence delirium among older medical inpatients. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 17(9), pp. 760-8.
Bo M, et al. Geriatric Ward Hospitalization Reduced Incidence Delirium Among Older Medical Inpatients. Am J Geriatr Psychiatry. 2009;17(9):760-8. PubMed PMID: 19705520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geriatric ward hospitalization reduced incidence delirium among older medical inpatients. AU - Bo,Mario, AU - Martini,Barbara, AU - Ruatta,Claudia, AU - Massaia,Massimiliano, AU - Ricauda,Nicoletta Aimonino, AU - Varetto,Antonella, AU - Astengo,Marco, AU - Torta,Riccardo, PY - 2009/8/26/entrez PY - 2009/8/26/pubmed PY - 2009/10/21/medline SP - 760 EP - 8 JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry JO - Am J Geriatr Psychiatry VL - 17 IS - 9 N2 - OBJECTIVES: Most strategies for delirium prevention in older hospitalized patients are common good clinical geriatric care. We investigated whether acute geriatric ward (AGW) hospitalization, compared with acute general medical ward (AGMW) hospitalization,is associated with reduced incident delirium in older medical inpatients. DESIGN: prospective observational study. SETTING: a tertiary care, university hospital in Torino. PARTICIPANTS: consecutive medical patients 70 years or older admitted from the emergency department to an AGW and to an AGMW were included. MEASUREMENTS: Baseline measures included demography, functional and psychocognitive status, comorbidity, physiological and clinical severity of acute illness. Incident delirium was evaluated by qualified psychiatrists according to the Confusion Assessment Method and the Delirium Rating Scale. RESULTS: Delirium occurred in 8 of 121 patients admitted to AGW (6.6%) and in 20 of 131 patients admitted to AGMW (15.2%). After adjustment for significant differences in baseline covariates between groups, AGW hospitalization remained independently associated with less incident delirium (relative risk 0.90, 95% confidence interval: 0.024-0.331, p <0.001). In a multivariable logistic model with delirium incidence as independent variable, AGW hospitalization was independently associated with lower delirium incidence (relative risk 0.039, 95% confidence interval: 0.007-0.214, p <0.001), whereas greater cognitive impairment (p <0.001), higher Acute Physiology and Chronic Health Evaluation II score (p 0.001) and recent stressful events (p <0.001) were associated with increased delirium incidence. CONCLUSION: AGW hospitalization is associated with less incident delirium among older medical inpatients. Despite inherent limitations of observational studies, these hypothesis-generating findings add to previous evidence of potential benefit in delirium prevention from geriatric consultation in several hospital settings. SN - 1545-7214 UR - https://www.unboundmedicine.com/medline/citation/19705520/Geriatric_ward_hospitalization_reduced_incidence_delirium_among_older_medical_inpatients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1064-7481(12)60794-5 DB - PRIME DP - Unbound Medicine ER -