The prevalence of delirium in an older acute surgical population and its effect on outcome

Jonathan Hewitt* (Corresponding Author), Stephanie Owen, Ben Carter, Michael J. Stechman, Hui Sian Tay, Matthew Greig, Caroline McCormack, Lyndsay Pearce, Kathryn McCarthy, Phyo K. Myint, Susan J. Moug

*Corresponding author for this work

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Abstract

Background: With an ageing population, an increasing number of older adults are admitted for assessment to acute surgical units. Older adults have specific factors that may influence outcomes, one of which is delirium (acute cognitive impairment). Objectives: To establish the prevalence of delirium on admission in an older acute surgical population and its effect on mortality. Secondary outcomes investigated include hospital readmission and length of hospital stay. Method: This observational multi-centre study investigated consecutive patients, ≥65 years, admitted to the acute surgical units of five UK hospitals during an eight-week period. On admission the Confusion Assessment Method (CAM) score was performed to detect delirium. The effect of delirium on important clinical outcomes was investigated using tests of association and logistic regression models. Results: The cohort consisted of 411 patients with a mean age of 77.3 years (SD 8.1). The prevalence of admission delirium was 8.8% (95% CI 6.2–11.9%) and cognitive impairment was 70.3% (95% CI 65.6–74.7%). The delirious group were not more likely to die at 30 or 90 days (OR 1.1, 95% CI 0.2 to 5.1, p = 0.67; OR 1.4, 95% CI 0.4 to 4.1. p = 0.82) or to be readmitted within 30 days of discharge (OR 0.9, 95% CI 0.4 to 2.2, p = 0.89). Length of hospital stay was significantly longer in the delirious group (median 8 vs. 5 days respectively, p = 0.009). Conclusion: Admission delirium occurs in just under 10% of older people admitted to acute surgical units, resulting in significantly longer hospital stays.
Original languageEnglish
Article number57
Number of pages8
JournalGeriatrics
Volume4
Issue number4
Early online date16 Oct 2019
DOIs
Publication statusPublished - Dec 2019

Keywords

  • cognitive impairment
  • delirium
  • older surgical patients

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    Hewitt, J., Owen, S., Carter, B., Stechman, M. J., Tay, H. S., Greig, M., McCormack, C., Pearce, L., McCarthy, K., Myint, P. K., & Moug, S. J. (2019). The prevalence of delirium in an older acute surgical population and its effect on outcome. Geriatrics, 4(4), [57]. https://doi.org/10.3390/geriatrics4040057