Turkish Journal of Geriatrics 2014 , Vol 17, Issue 1
DELIRIUM IN OLDER EMERGENCY DEPARTMENT PATIENTS IS ASSOCIATED WITH INCREASED IN-HOSPITAL MORTALITY
Özge DUMAN ATİLLA, Savaş SEZİK, Seda DAĞAR, Arif AKKAYA, Ersin AKSAY
Tepecik Eğitim ve Araştırma Hastanesi Acil Tıp Bölümü İZMİR Introduction: In this study, it was aimed determine in-hospital mortality, in-hospital length of stay, and independent predictors that predisposes to the development of delirium for identifying geriatric emergency department patients with delirium as well as those admitted to the hospital.

Materials and Method: Patients who were admitted to emergency department were included to the study if they were 65 years and older and hospitalised. A shortened version of Confusion Assessment Method was used to determine the presence of delirium during the initial emergency department management. Primary medical diagnosis and clinical outcome of the patients were followed-up from hospital electronic records.

Results: Six hundred and ninety three patients were enrolled in the study. The prevalence of delirium was 7.1% (n=49) in admitted geriatric emergency department patients. In-hospital mortality was more frequently observed in patients with delirium than in those without delirium (28.6% and 9%, respectively, p<0.001, OR=4.041, 95% CI=2.056-7.945). The hospital length of stay of patients with delirium was prolonged compared to patients without delirium (9 days and. 6 days, respectively, p=0.046). Predisposing factors for developing delirium were determined as previous history of cerebrovascular accident (OR=1.746, 95% CI=0.692-4.405), and sepsis (OR=59.915; 95% CI=11.880-253.851), pneumonia (OR=6.828; 95% CI=2.081-22.405), electrolyte imbalance (OR=23.020; 95% CI=5.296-10.063) or having current cerebrovascular accidents (OR=12.166; 95% CI=5.354-27.647) as their primary medical diagnosis.

Conclusion: Delirium is associated with increased in-hospital mortality and prolonged hospital length of stay in elderly admitted emergency department patients. Keywords : Delirium; Emergency Medical Services; Mortality; Aged