Delirium in the geriatric unit: proton-pump inhibitors and other risk factors
Iwona Otremba, Krzysztof Wilczyński, Jan SzewieczekDepartment of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, PolandBackground: Delirium remains a major nosocomial complication of hospitalized elderly. Predictive models for delirium may be useful for id...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-04-01
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| Series: | Clinical Interventions in Aging |
| Subjects: | |
| Online Access: | https://www.dovepress.com/delirium-in-the-geriatric-unit-proton-pump-inhibitors-and-other-risk-f-peer-reviewed-article-CIA |
| _version_ | 1818937266070880256 |
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| author | Otremba I Wilczyński K Szewieczek J |
| author_facet | Otremba I Wilczyński K Szewieczek J |
| author_sort | Otremba I |
| collection | DOAJ |
| description | Iwona Otremba, Krzysztof Wilczyński, Jan SzewieczekDepartment of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, PolandBackground: Delirium remains a major nosocomial complication of hospitalized elderly. Predictive models for delirium may be useful for identification of high-risk patients for implementation of preventive strategies.Objective: Evaluate specific factors for development of delirium in a geriatric ward setting.Methods: Prospective cross-sectional study comprised 675 consecutive patients aged 79.2±7.7 years (66% women and 34% men), admitted to the subacute geriatric ward of a multiprofile university hospital after exclusion of 113 patients treated with antipsychotic medication because of behavioral disorders before admission. Comprehensive geriatric assessments including a structured interview, physical examination, geriatric functional assessment, blood sampling, ECG, abdominal ultrasound, chest X-ray, Confusion Assessment Method for diagnosis of delirium, Delirium-O-Meter to assess delirium severity, Richmond Agitation-Sedation Scale to assess sedation or agitation, visual analog scale and Doloplus-2 scale to assess pain level were performed.Results: Multivariate logistic regression analysis revealed five independent factors associated with development of delirium in geriatric inpatients: transfer between hospital wards (odds ratio [OR] =2.78; confidence interval [CI] =1.54–5.01; P=0.001), preexisting dementia (OR =2.29; CI =1.44–3.65; P<0.001), previous delirium incidents (OR =2.23; CI =1.47–3.38; P<0.001), previous fall incidents (OR =1.76; CI =1.17–2.64; P=0.006), and use of proton-pump inhibitors (OR =1.67; CI =1.11–2.53; P=0.014).Conclusion: Transfer between hospital wards, preexisting dementia, previous delirium incidents, previous fall incidents, and use of proton-pump inhibitors are predictive of development of delirium in the geriatric inpatient setting.Keywords: delirium, geriatric ward, comprehensive geriatric assessment, Confusion Assessment Method, Delirium-O-Meter, Richmond Agitation-Sedation ScaleA Letter to the Editor has been received and published for this article. |
| first_indexed | 2024-12-20T05:49:13Z |
| format | Article |
| id | doaj.art-bd1968272fff40d2a93118c67b42c897 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-20T05:49:13Z |
| publishDate | 2016-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-bd1968272fff40d2a93118c67b42c8972022-12-21T19:51:13ZengDove Medical PressClinical Interventions in Aging1178-19982016-04-01Volume 1139740526259Delirium in the geriatric unit: proton-pump inhibitors and other risk factorsOtremba IWilczyński KSzewieczek JIwona Otremba, Krzysztof Wilczyński, Jan SzewieczekDepartment of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, PolandBackground: Delirium remains a major nosocomial complication of hospitalized elderly. Predictive models for delirium may be useful for identification of high-risk patients for implementation of preventive strategies.Objective: Evaluate specific factors for development of delirium in a geriatric ward setting.Methods: Prospective cross-sectional study comprised 675 consecutive patients aged 79.2±7.7 years (66% women and 34% men), admitted to the subacute geriatric ward of a multiprofile university hospital after exclusion of 113 patients treated with antipsychotic medication because of behavioral disorders before admission. Comprehensive geriatric assessments including a structured interview, physical examination, geriatric functional assessment, blood sampling, ECG, abdominal ultrasound, chest X-ray, Confusion Assessment Method for diagnosis of delirium, Delirium-O-Meter to assess delirium severity, Richmond Agitation-Sedation Scale to assess sedation or agitation, visual analog scale and Doloplus-2 scale to assess pain level were performed.Results: Multivariate logistic regression analysis revealed five independent factors associated with development of delirium in geriatric inpatients: transfer between hospital wards (odds ratio [OR] =2.78; confidence interval [CI] =1.54–5.01; P=0.001), preexisting dementia (OR =2.29; CI =1.44–3.65; P<0.001), previous delirium incidents (OR =2.23; CI =1.47–3.38; P<0.001), previous fall incidents (OR =1.76; CI =1.17–2.64; P=0.006), and use of proton-pump inhibitors (OR =1.67; CI =1.11–2.53; P=0.014).Conclusion: Transfer between hospital wards, preexisting dementia, previous delirium incidents, previous fall incidents, and use of proton-pump inhibitors are predictive of development of delirium in the geriatric inpatient setting.Keywords: delirium, geriatric ward, comprehensive geriatric assessment, Confusion Assessment Method, Delirium-O-Meter, Richmond Agitation-Sedation ScaleA Letter to the Editor has been received and published for this article.https://www.dovepress.com/delirium-in-the-geriatric-unit-proton-pump-inhibitors-and-other-risk-f-peer-reviewed-article-CIADeliriumgeriatric wardcomprehensive geriatric assessmentConfusion Assessment MethodDelirium-O-MeterRichmond Agitation-Sedation Scale |
| spellingShingle | Otremba I Wilczyński K Szewieczek J Delirium in the geriatric unit: proton-pump inhibitors and other risk factors Clinical Interventions in Aging Delirium geriatric ward comprehensive geriatric assessment Confusion Assessment Method Delirium-O-Meter Richmond Agitation-Sedation Scale |
| title | Delirium in the geriatric unit: proton-pump inhibitors and other risk factors |
| title_full | Delirium in the geriatric unit: proton-pump inhibitors and other risk factors |
| title_fullStr | Delirium in the geriatric unit: proton-pump inhibitors and other risk factors |
| title_full_unstemmed | Delirium in the geriatric unit: proton-pump inhibitors and other risk factors |
| title_short | Delirium in the geriatric unit: proton-pump inhibitors and other risk factors |
| title_sort | delirium in the geriatric unit proton pump inhibitors and other risk factors |
| topic | Delirium geriatric ward comprehensive geriatric assessment Confusion Assessment Method Delirium-O-Meter Richmond Agitation-Sedation Scale |
| url | https://www.dovepress.com/delirium-in-the-geriatric-unit-proton-pump-inhibitors-and-other-risk-f-peer-reviewed-article-CIA |
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