Document Detail


Risk factors for developing delirium in older patients admitted to general medical wards.
MedLine Citation:
PMID:  21721434     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Delirium in older patients is common and leads to poor clinical outcomes. It is, however, preventable if its risk factors are identified and modified accordingly.
OBJECTIVE: To determine risk factors associated with delirium in hospitalized older patients admitted to general medical wards at Siriraj Hospital.
MATERIAL AND METHOD: A prospective observational study was conducted at general medical wards, Siriraj Hospital. All consecutive patients aged 70 years or older admitted during study period were assessed and followed until discharge. A diagnosis of delirium was made if patients developed symptoms which fulfilled DSM IV criteria. Information regarding demographic data, co-morbid illnesses, preexisting cognitive status and functional status was collected at admission. Factorf associated with delirium were analyzed using logistic regression models.
RESULTS: Risk factors associated with developing delirium identified from univariate analysis were female gender, age more than 80 years-old, having 4 or more co-morbidities, azothemia, hyponatremia, presence of infection, severe illness, preexisting dementia, depression, and impaired basic activities of daily living. After adjusted in multivariate analysis; factors those remained statistically significant were preexisting dementia (OR = 5.52, 95% CI = 2.51-12.14), severe illness (OR = 5.18, 95% CI = 2.10-12.76) presence of infection (OR = 2.54, 95% CI = 1.15-5.61) and azothemia (OR = 2.55, 95% CI = 1.205.40).
CONCLUSION: Pre-existing dementia and illness severity were strongly associated with developing delirium in older patients in the present study, which is concordant with previous studies. Other factors such as presence of infection and azothemia are modifiable factors that could potentially be important targets, along with other factors identified in the present study, for implementing intervention in order to prevent delirium in this population.
Authors:
Varalak Srinonprasert; Sorapop Pakdeewongse; Jintana Assanasen; Waricha Eiamjinnasuwat; Achara Sirisuwat; Duangsawang Limmathuroskul; Rungnirand Praditsuwan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  94 Suppl 1     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-07-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  S99-104     Citation Subset:  IM    
Affiliation:
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. tevsn@mahidol.ac.th
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