Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand

Aim: Delirium, a common disorder in hospitalized older patients, frequently results in unfavorable consequences. Previous studies in different settings have provided conflicting results regarding clinical outcomes and mortality. We aimed to study three clinical outcomes - length of stay (LOS), in-ho...

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Main Authors: Rungnirand Praditsuwan, Achara Sirisuwat, Jintana Assanasen, Waricha Eiamjinnasuwat, Sorapop Pakdeewongse, Duangsawang Limmathuroskul, Varalak Srinonprasert
Other Authors: Mahidol University
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Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/32135
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spelling th-mahidol.321352018-10-19T12:48:23Z Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand Rungnirand Praditsuwan Achara Sirisuwat Jintana Assanasen Waricha Eiamjinnasuwat Sorapop Pakdeewongse Duangsawang Limmathuroskul Varalak Srinonprasert Mahidol University Medicine Nursing Social Sciences Aim: Delirium, a common disorder in hospitalized older patients, frequently results in unfavorable consequences. Previous studies in different settings have provided conflicting results regarding clinical outcomes and mortality. We aimed to study three clinical outcomes - length of stay (LOS), in-hospital mortality and 3-month mortality - among delirious Thai older patients. Methods: A prospective observational study was carried out in a university hospital in Thailand. All patients aged older than 70 years admitted to general medical wards were included. Delirium assessments were undertaken within the first 24h of admission and serially until discharge. Subsequent assessments were carried out at 3 months after discharge. Delirium was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria. Factors associated with mortality were determined by using logistic regression models. Results: LOS was significantly longer in the delirium group (10 and 8 days, P=0.001). Furthermore, the delirium group had higher in-hospital and 3-month mortality (P<0.001). Factors significantly associated with in-hospital mortality in multivariate analysis were age more than 80 years (AOR 2.74, 95% CI 1.05-7.15), malignancy (AOR 3.11, 95% CI 1.16-8.33), severe illness (AOR 3.75, 95% CI 1.38-10.20) and delirium (AOR 7.34, 95% CI 1.51-35.69). Delirium remained a strong predictor for 3-month mortality in multivariate analysis with AOR of 3.33 (95% CI 1.45-7.62) Conclusions: Delirium was associated with prolonged hospital-stay and was the strongest predictor for mortality among older hospitalized patients. It requires serious attention from physicians, healthcare administrators and policy makers to implement an appropriate management plan for this high-burden issue. Geriatr Gerontol Int 2013; 13: 972-977.© 2013 Japan Geriatrics Society. 2018-10-19T05:15:16Z 2018-10-19T05:15:16Z 2013-10-01 Article Geriatrics and Gerontology International. Vol.13, No.4 (2013), 972-977 10.1111/ggi.12041 14470594 14441586 2-s2.0-84885895148 https://repository.li.mahidol.ac.th/handle/123456789/32135 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84885895148&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
Nursing
Social Sciences
spellingShingle Medicine
Nursing
Social Sciences
Rungnirand Praditsuwan
Achara Sirisuwat
Jintana Assanasen
Waricha Eiamjinnasuwat
Sorapop Pakdeewongse
Duangsawang Limmathuroskul
Varalak Srinonprasert
Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand
description Aim: Delirium, a common disorder in hospitalized older patients, frequently results in unfavorable consequences. Previous studies in different settings have provided conflicting results regarding clinical outcomes and mortality. We aimed to study three clinical outcomes - length of stay (LOS), in-hospital mortality and 3-month mortality - among delirious Thai older patients. Methods: A prospective observational study was carried out in a university hospital in Thailand. All patients aged older than 70 years admitted to general medical wards were included. Delirium assessments were undertaken within the first 24h of admission and serially until discharge. Subsequent assessments were carried out at 3 months after discharge. Delirium was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria. Factors associated with mortality were determined by using logistic regression models. Results: LOS was significantly longer in the delirium group (10 and 8 days, P=0.001). Furthermore, the delirium group had higher in-hospital and 3-month mortality (P<0.001). Factors significantly associated with in-hospital mortality in multivariate analysis were age more than 80 years (AOR 2.74, 95% CI 1.05-7.15), malignancy (AOR 3.11, 95% CI 1.16-8.33), severe illness (AOR 3.75, 95% CI 1.38-10.20) and delirium (AOR 7.34, 95% CI 1.51-35.69). Delirium remained a strong predictor for 3-month mortality in multivariate analysis with AOR of 3.33 (95% CI 1.45-7.62) Conclusions: Delirium was associated with prolonged hospital-stay and was the strongest predictor for mortality among older hospitalized patients. It requires serious attention from physicians, healthcare administrators and policy makers to implement an appropriate management plan for this high-burden issue. Geriatr Gerontol Int 2013; 13: 972-977.© 2013 Japan Geriatrics Society.
author2 Mahidol University
author_facet Mahidol University
Rungnirand Praditsuwan
Achara Sirisuwat
Jintana Assanasen
Waricha Eiamjinnasuwat
Sorapop Pakdeewongse
Duangsawang Limmathuroskul
Varalak Srinonprasert
format Article
author Rungnirand Praditsuwan
Achara Sirisuwat
Jintana Assanasen
Waricha Eiamjinnasuwat
Sorapop Pakdeewongse
Duangsawang Limmathuroskul
Varalak Srinonprasert
author_sort Rungnirand Praditsuwan
title Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand
title_short Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand
title_full Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand
title_fullStr Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand
title_full_unstemmed Short-term clinical outcomes in delirious older patients: A study at general medical wards in a university hospital in Thailand
title_sort short-term clinical outcomes in delirious older patients: a study at general medical wards in a university hospital in thailand
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/32135
_version_ 1763495806238720000