학술논문

Risk factors and outcomes of delirium in hospitalized older Ghanaians.
Document Type
Article
Source
International Journal of Geriatric Psychiatry. Apr2023, Vol. 38 Issue 4, p1-9. 9p.
Subject
*LENGTH of stay in hospitals
*SCIENTIFIC observation
*CONFIDENCE intervals
*STROKE
*MULTIPLE regression analysis
*MORTALITY
*TREATMENT effectiveness
*RISK assessment
*INFECTION
*DELIRIUM
*HOSPITAL care of older people
*GHANAIANS
*DISEASE prevalence
*ODDS ratio
*LONGITUDINAL method
*PROPORTIONAL hazards models
*OLD age
Language
ISSN
0885-6230
Abstract
Objectives: Delirium has been rarely studied in older West Africans. We sought to investigate its correlates and outcomes in hospitalized older Ghanaians. Methods: This was a one‐month prospective observational study. Delirium prevalence was assessed within 24 h of admission using the Confusion Assessment Method (CAM). Incident delirium was determined with repeat CAM assessments on post‐admission days 4, 7, 14, 21 and 28, after censoring participants with prevalent delirium. Multivariate logistic regression analyses were used to explore risk factors. Estimates of adjusted hazard ratios for mortality were derived with the discrete time version of the Cox regression model for time invariant explanatory variables. Results: Among 483 participants, 250 (51.8%, 95% CI: 47.3–56.3) had prevalent delirium while 10 of the remaining 233 (4.3%, 95% CI: 2.1–7.8) developed incident delirium. Being older than 80 years (adjusted odds ratio (OR) = 2.1, 95% CI: 1.2–3.6), having no formal education (OR = 2.2, 95% CI: 1.4–3.4), stroke (OR = 1.8, 95% CI: 1.1–3.0), infection (OR = 1.9, 95% CI: 1.2–3.0), and high Triage Early Warning Score (OR = 6.9, 95% CI: 2.5–19.0) predicted delirium. Delirium (adjusted hazard ratio (HR) = 1.8, 95% CI: 1.0–3.3) and high TEWS (HR = 4.6 (95% CI: 1.7–12.7) at baseline predicted mortality. These factors also predicted longer hospital stay. Conclusion: Over half of hospital‐treated older Ghanaians in the present study had delirium on the first day of admission. The syndrome prolonged hospitalisation and increased mortality risk. Future studies in West Africa may investigate the epidemiology of delirium in primary care and community settings. Key points: Delirium is present on the day of admission in over half of hospitalized older adults in the study sample.Advanced age, lack of formal education and high Triage Early Warning Score are associated with higher risk of delirium.Delirium independently predicts higher mortality risk and prolonged hospital stay. [ABSTRACT FROM AUTHOR]