Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients
Background: In an ever-aging society, health care systems will be confronted with an increasing number of patients over 80 years (“the very old”). Currently, knowledge about and recommendations for delirium management are often based on studies in patients aged 60 to 65 years. It is not clear whethe...
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doaj-0b1ffed7567049248745d72ec6a3266b2021-05-11T04:20:09ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-05-011210.3389/fpsyt.2021.655087655087Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 PatientsJustus Marquetand0Justus Marquetand1Leonie Bode2Simon Fuchs3Florian Hildenbrand4Jutta Ernst5Roland von Kaenel6Soenke Boettger7Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zurich, Zurich, SwitzerlandDepartment of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tubingen, Tubingen, GermanyDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zurich, Zurich, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zurich, Zurich, SwitzerlandDepartment of Gastroenterology University Hospital Zürich, University of Zurich, Zurich, SwitzerlandInstitute of Nursing Science, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zurich, Zurich, SwitzerlandUniversity Hospital Zurich, University Zurich, Zurich, SwitzerlandBackground: In an ever-aging society, health care systems will be confronted with an increasing number of patients over 80 years (“the very old”). Currently, knowledge about and recommendations for delirium management are often based on studies in patients aged 60 to 65 years. It is not clear whether these findings apply to patients ≥80 years.Aim: Comparison of younger and older patients with delirium, especially regarding risk factors.Methods: In this prospective cohort study, within 1-year, 5,831 patients (18–80 years: n = 4,730; ≥80: n = 1,101) with delirium were enrolled. The diagnosis of delirium was based on the Delirium Observation screening scale (DOS), Intensive Care Delirium Screening Checklist (ICDSC) and a DSM (Diagnostic and Statistical Manual)-5 construct of nursing instrument. Sociodemographic trajectories, as well as the relevant predisposing and precipitating factors for delirium, were assessed via a multiple regression analysis.Results: The very old were more commonly admitted as emergencies (OR 1.42), had a greater mortality risk (OR 1.56) and displayed fewer precipitating risk factors for the development of a delirium, although the number of diagnoses were not different (p = 0.325). Predisposing factors were sufficient almost alone for the development of delirium in patients ≥ 80 years of age; in 18–80 years of age, additional precipitating factors had to occur to make a delirium possible.Conclusion: When relevant predisposing factors for delirium are apparent, patients over 80 years of age require comparatively few or no precipitating factors to develop delirium. This finding should be taken into account at hospitalization and may allow better treatment of delirium in the future.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.655087/fulldeliriumvery oldrisk factorscomparisonprospective |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Justus Marquetand Justus Marquetand Leonie Bode Simon Fuchs Florian Hildenbrand Jutta Ernst Roland von Kaenel Soenke Boettger |
spellingShingle |
Justus Marquetand Justus Marquetand Leonie Bode Simon Fuchs Florian Hildenbrand Jutta Ernst Roland von Kaenel Soenke Boettger Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients Frontiers in Psychiatry delirium very old risk factors comparison prospective |
author_facet |
Justus Marquetand Justus Marquetand Leonie Bode Simon Fuchs Florian Hildenbrand Jutta Ernst Roland von Kaenel Soenke Boettger |
author_sort |
Justus Marquetand |
title |
Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients |
title_short |
Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients |
title_full |
Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients |
title_fullStr |
Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients |
title_full_unstemmed |
Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients |
title_sort |
risk factors for delirium are different in the very old: a comparative one-year prospective cohort study of 5,831 patients |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Psychiatry |
issn |
1664-0640 |
publishDate |
2021-05-01 |
description |
Background: In an ever-aging society, health care systems will be confronted with an increasing number of patients over 80 years (“the very old”). Currently, knowledge about and recommendations for delirium management are often based on studies in patients aged 60 to 65 years. It is not clear whether these findings apply to patients ≥80 years.Aim: Comparison of younger and older patients with delirium, especially regarding risk factors.Methods: In this prospective cohort study, within 1-year, 5,831 patients (18–80 years: n = 4,730; ≥80: n = 1,101) with delirium were enrolled. The diagnosis of delirium was based on the Delirium Observation screening scale (DOS), Intensive Care Delirium Screening Checklist (ICDSC) and a DSM (Diagnostic and Statistical Manual)-5 construct of nursing instrument. Sociodemographic trajectories, as well as the relevant predisposing and precipitating factors for delirium, were assessed via a multiple regression analysis.Results: The very old were more commonly admitted as emergencies (OR 1.42), had a greater mortality risk (OR 1.56) and displayed fewer precipitating risk factors for the development of a delirium, although the number of diagnoses were not different (p = 0.325). Predisposing factors were sufficient almost alone for the development of delirium in patients ≥ 80 years of age; in 18–80 years of age, additional precipitating factors had to occur to make a delirium possible.Conclusion: When relevant predisposing factors for delirium are apparent, patients over 80 years of age require comparatively few or no precipitating factors to develop delirium. This finding should be taken into account at hospitalization and may allow better treatment of delirium in the future. |
topic |
delirium very old risk factors comparison prospective |
url |
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.655087/full |
work_keys_str_mv |
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