The factors which predispose to the development of delirium patients hospitalized in the geriatric ward

Introduction. Delirium is acute cognitive disorder comorbid with impaired consciousness, the rhythm of sleep and wakefulness and psychomotor activity. It occurs in 30-50% of patients on geriatric wards. Increases of 25–33% mortality.

Aim. The aim of the study was to analyze the prevalence of risk factors and to identify predictors of delirium in patients hospitalized in the geriatric ward.

Material and methods. The study included 200 consecutive patients admitted to the Geriatric Ward an average age of 80.3 ± 7.58 years ( ± SD) — 65% of women and 35% of men, were divided into group D (with symptoms of delirium) and group N (no symptoms). Independence and the ability to move rated by the Barthel scale, and IADL, the intensity of pain by VAS or DOLOPLUS, mental status by MMSE, presence of depression by GDS, occurrence of delirium by CAM scale, depth of delirium by DOM, agitation-sedation by RASS.

Results. Group D consisted of 11, N — 189 patients. The most common risk factors for delirium were: dependence (91% vs. 53%, p < 0.000), dementia (73% vs. 39%, p < 0.000), pain (67% vs. 39%, p < 0.000), aversion to food intake (64% vs. 2%, p < 0.000), loss of mobility (55% vs. 27%, p < 0.000), dehydration (27% vs. 6%, p < 0.000), benzodiazepines (18% vs. 2%, p < 0.000), fall during hospitalization (18% vs. 2%, p < 0.000), pressure ulcers (27% vs. 4%, p < 0.000), neuroleptics (45% vs. 21%, p = 0.001), urinary incontinence (64% vs. 39%, p = 0.001), urinary tract infection (36% vs. 16%, p = 0.002), bladder catheterization (27% vs. 12 %, p = 0.013).

Conclusions. Patients with delirium were saddled with more risk factors for delirium than patients in the control group. In these patients showed an extension of the period of hospitalization.

Nursing Topics 2015; 23 (1): 46–50