Frequency of delirium and associated factors in patients from a neurological emergency department
Background: Delirium is an important cause of morbidity and mortality in the general hospitalized population. Few information exists on risk factors in patients with neurological disease. Objective: This study was to analyze risk factors for delirium in patients presenting to a neurological emergenc...
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2023-10-01
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| Series: | Revista Mexicana de Neurociencia |
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| Online Access: | https://www.revmexneurociencia.com/frame_esp.php?id=222 |
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| author | Jesús A. Violante-Villanueva Moisés E. Lázaro-Jarquín Jesús Ramírez-Bermúdez Victoria Martínez-Angeles Javier A. Galnares-Olalde Karina Carrillo-Loza Arturo Martínez-Piña Xiomara García Salazar Juan C. López-Hernández |
| author_facet | Jesús A. Violante-Villanueva Moisés E. Lázaro-Jarquín Jesús Ramírez-Bermúdez Victoria Martínez-Angeles Javier A. Galnares-Olalde Karina Carrillo-Loza Arturo Martínez-Piña Xiomara García Salazar Juan C. López-Hernández |
| author_sort | Jesús A. Violante-Villanueva |
| collection | DOAJ |
| description | Background: Delirium is an important cause of morbidity and mortality in the general hospitalized population. Few information exists on risk factors in patients with neurological disease. Objective: This study was to analyze risk factors for delirium in patients presenting to a neurological emergency department. Methods: This study was observational prospective cohort study. We included all patients with neurological disease, admitted to the emergency department with a stay of more than 8 h, in the period from January to April 2022. The confusion assessment method-intensive care unit delirium detection instrument and DSM-5 criteria were applied to all patients. We obtained information on epidemiological, clinical, and paraclinical variables at the time of admission. Through a univariate and multivariate logistic regression model, we analyzed risk factors for delirium. Results: Of 3661 patients treated in the emergency department, 189 patients were included, 60.8% male gender, age 48 ± 19 years; 44 (23.2%) met criteria for delirium, 81% were diagnosed on admission; delirium scale score/index 12 (interquartile range [IQR] 10-12), and duration of delirium 5 (IQR 2-11) days. Clinical history for risk of delirium: previous delirium (odds ratio [OR] 3.9, 95% CI 2.4-6.1, p = 0.003), stroke (OR 2.2, 95% CI 1.4-3.9, p = 0.009), neurosurgery (OR 2.1, 95% CI 1.2-3.8, p = 0.024), and use of psychoactive drugs (OR 2.5, CI9 5% 1.3-4.6, p = 0.021). The following variables were independent risk factors for delirium through the multivariate logistic regression model:uncontrolled crisis [OR 5.4 (95% CI 1.2-22.9), p = 0.023], supratentorial structural brain lesion [OR 6.1 (95% CI 1.7-21.2), p = 0.004], and neuroinfection OR 9.6 (95% CI 2.9-31.4), p ≤ 0.001]. Conclusions: The frequency of delirium is 23.2% in patients presenting to the neurological emergency department; uncontrolled epilepsy, neuroinfection, and supratentorial brain lesions are independent risk factors for delirium.
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| first_indexed | 2024-03-12T21:29:16Z |
| format | Article |
| id | doaj.art-1ae5cde8f1944c0d939a08307cfe622f |
| institution | Directory Open Access Journal |
| issn | 2604-6180 |
| language | English |
| last_indexed | 2024-03-12T21:29:16Z |
| publishDate | 2023-10-01 |
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| series | Revista Mexicana de Neurociencia |
| spelling | doaj.art-1ae5cde8f1944c0d939a08307cfe622f2023-07-27T22:39:40ZengPermanyerRevista Mexicana de Neurociencia2604-61802023-10-0124410.24875/RMN.22000083Frequency of delirium and associated factors in patients from a neurological emergency departmentJesús A. Violante-Villanueva0Moisés E. Lázaro-Jarquín1Jesús Ramírez-Bermúdez2Victoria Martínez-Angeles3Javier A. Galnares-Olalde4Karina Carrillo-Loza5Arturo Martínez-Piña6Xiomara García Salazar7Juan C. López-Hernández8Department of Neurological Emergency, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoDepartment of Neurological Emergency, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoDepartment of Neuropsychiatry, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoDepartment of Neuropsychiatry, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoDepartment of Neurology, Instituto Nacional de Neurología y Neurocirugía. Ciudad de México, MéxicoDepartment of Neurology, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoDepartment of Neurology, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoDepartment of Neurological Emergency, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoDepartment of Neurological Emergency, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, MéxicoBackground: Delirium is an important cause of morbidity and mortality in the general hospitalized population. Few information exists on risk factors in patients with neurological disease. Objective: This study was to analyze risk factors for delirium in patients presenting to a neurological emergency department. Methods: This study was observational prospective cohort study. We included all patients with neurological disease, admitted to the emergency department with a stay of more than 8 h, in the period from January to April 2022. The confusion assessment method-intensive care unit delirium detection instrument and DSM-5 criteria were applied to all patients. We obtained information on epidemiological, clinical, and paraclinical variables at the time of admission. Through a univariate and multivariate logistic regression model, we analyzed risk factors for delirium. Results: Of 3661 patients treated in the emergency department, 189 patients were included, 60.8% male gender, age 48 ± 19 years; 44 (23.2%) met criteria for delirium, 81% were diagnosed on admission; delirium scale score/index 12 (interquartile range [IQR] 10-12), and duration of delirium 5 (IQR 2-11) days. Clinical history for risk of delirium: previous delirium (odds ratio [OR] 3.9, 95% CI 2.4-6.1, p = 0.003), stroke (OR 2.2, 95% CI 1.4-3.9, p = 0.009), neurosurgery (OR 2.1, 95% CI 1.2-3.8, p = 0.024), and use of psychoactive drugs (OR 2.5, CI9 5% 1.3-4.6, p = 0.021). The following variables were independent risk factors for delirium through the multivariate logistic regression model:uncontrolled crisis [OR 5.4 (95% CI 1.2-22.9), p = 0.023], supratentorial structural brain lesion [OR 6.1 (95% CI 1.7-21.2), p = 0.004], and neuroinfection OR 9.6 (95% CI 2.9-31.4), p ≤ 0.001]. Conclusions: The frequency of delirium is 23.2% in patients presenting to the neurological emergency department; uncontrolled epilepsy, neuroinfection, and supratentorial brain lesions are independent risk factors for delirium. https://www.revmexneurociencia.com/frame_esp.php?id=222Delirium. Neurological disease. Clinical risk factors. Risk image factors. Frequency. Neurological emergencies. |
| spellingShingle | Jesús A. Violante-Villanueva Moisés E. Lázaro-Jarquín Jesús Ramírez-Bermúdez Victoria Martínez-Angeles Javier A. Galnares-Olalde Karina Carrillo-Loza Arturo Martínez-Piña Xiomara García Salazar Juan C. López-Hernández Frequency of delirium and associated factors in patients from a neurological emergency department Revista Mexicana de Neurociencia Delirium. Neurological disease. Clinical risk factors. Risk image factors. Frequency. Neurological emergencies. |
| title | Frequency of delirium and associated factors in patients from a neurological emergency department |
| title_full | Frequency of delirium and associated factors in patients from a neurological emergency department |
| title_fullStr | Frequency of delirium and associated factors in patients from a neurological emergency department |
| title_full_unstemmed | Frequency of delirium and associated factors in patients from a neurological emergency department |
| title_short | Frequency of delirium and associated factors in patients from a neurological emergency department |
| title_sort | frequency of delirium and associated factors in patients from a neurological emergency department |
| topic | Delirium. Neurological disease. Clinical risk factors. Risk image factors. Frequency. Neurological emergencies. |
| url | https://www.revmexneurociencia.com/frame_esp.php?id=222 |
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