Delirium in Hospitalized Elderly Patients and Post-Discharge Mortality

OBJECTIVE: To determine the impact of delirium on post-discharge mortality in hospitalized older patients. INTRODUCTION: Delirium is frequent in hospitalized older patients and correlates with high hospital mortality. There are only a few studies about its impact on post-discharge mortality. METHODS: This is a prospective study of patients over 60 years old who were hospitalized in the Geriatric Unit at Hospital das Clínicas of São Paulo between May 2006 and March 2007. Upon admission, demographics, comorbidities, number of drugs taken, and serum albumin concentration were evaluated for each patient. Delirium was diagnosed according to the DSM-IV criteria. Patients were divided into group A (with delirium) and group B (without delirium). One year after discharge, the patients or their caregivers were contacted to assess days of survival. RESULTS: The sample included 199 patients, 66 (33%) of whom developed delirium (Group A). After one year, 33 (50%) group A patients had died, and 45 (33.8%) group B patients had died (p = 0.03). There was a significant statistical difference in average age (p = 0.001) and immobility (p <0.001) between groups A and B. There were no statistically significant differences between groups A and B in number of drugs taken greater than four (p = 0.62), sex (p = 0.54) and number of diagnoses greater than four (p = 0.21). According to a multivariate analysis, delirium was not an independent predictor of post-discharge mortality. The predictors of post-discharge mortality were age > 80 years (p = 0.029), albumin concentration < 3.5 g/dl (p = 0.001) and immobility (p = 0.007). CONCLUSION: Delirium is associated with higher post-discharge mortality as a dependent predictor

Association between delirium superimposed on dementia and 12-mo mortality in acutely ill older adults; 2009–2015 (<i>n</i> = 1,144 discharges/976 patients).

<p>Association between delirium superimposed on dementia and 12-mo mortality in acutely ill older adults; 2009–2015 (<i>n</i> = 1,144 discharges/976 patients).</p

Association between delirium superimposed on dementia and hospital mortality in acutely ill older adults, 2009–2015 (<i>n</i> = 1,409 admissions/1,204 patients).

<p>Association between delirium superimposed on dementia and hospital mortality in acutely ill older adults, 2009–2015 (<i>n</i> = 1,409 admissions/1,204 patients).</p

Characteristics of acutely ill hospitalized older adults, according to delirium and dementia diagnosis, 2009–2015.

<p>Characteristics of acutely ill hospitalized older adults, according to delirium and dementia diagnosis, 2009–2015.</p

Probability of survival according to delirium and dementia diagnosis.

<p>(A) Kaplan–Meier estimates representing the probability of survival in the hospital according to delirium and dementia diagnosis, with a corresponding log-rank test indicating a statistically significant difference between the groups. (B) Kaplan–Meier estimates representing the probability of survival over 12 mo according to delirium and dementia diagnosis, with a corresponding log-rank test indicating a statistically significant difference between the groups.</p