Introduction. Delirium is a clinical syndrome with a high incidence in elderly patients. Its clinical and economical repercussions heavily impact on daily geriatric practice, especially in the hospital context. In this study we compared a sample of hospitalized elderly patients with diagnosis of delirium with a control group, in order to identify clinical or laboratory parameters potentially associated with this clinical syndrome. Patients and methods. From January 2007 to December 2009 we enrolled 578 patients (mean age: 82.0 ± 6.8) admitted to Internal Medicine University ward of S. Anna Hospital of Ferrara or Gerontology and Geriatrics Institute of Perugia University. 140 patients developed delirium during hospital stay (DSM-IV clinical diagnosis supported by Confusion Assessment Method). The remaining 438 patients did not develop delirium, and represented the control group. All these patients were clinically free from dementia. Results. Patients with delirium were older, more frequently not married and had a higher degree of physical disability compared to controls. In patients with delirium the mean duration of in-hospital stay was 4 days longer than control group. Furthermore, delirium was significantly associated with increased BUN/ creatinine ratio, CRP, and BSR values, and with reduced values of arterial blood pressure (both diastolic and systolic), HDL cholesterol, total serum proteins, serum albumin, and serum iron. Conclusions. Our results confirm that in hospitalized elderly patient there is an association between onset of delirium and advanced age, poor functional status. Furthermore this study confirms the association between delirium onset and clinical/laboratory markers of dehydration, systemic inflammation, and malnutrition.
Fattori associati all’insorgenza di delirium in un campione di pazienti anziani ospedalizzati
BONETTI, Francesco;ZULIANI, Giovanni
2012
Abstract
Introduction. Delirium is a clinical syndrome with a high incidence in elderly patients. Its clinical and economical repercussions heavily impact on daily geriatric practice, especially in the hospital context. In this study we compared a sample of hospitalized elderly patients with diagnosis of delirium with a control group, in order to identify clinical or laboratory parameters potentially associated with this clinical syndrome. Patients and methods. From January 2007 to December 2009 we enrolled 578 patients (mean age: 82.0 ± 6.8) admitted to Internal Medicine University ward of S. Anna Hospital of Ferrara or Gerontology and Geriatrics Institute of Perugia University. 140 patients developed delirium during hospital stay (DSM-IV clinical diagnosis supported by Confusion Assessment Method). The remaining 438 patients did not develop delirium, and represented the control group. All these patients were clinically free from dementia. Results. Patients with delirium were older, more frequently not married and had a higher degree of physical disability compared to controls. In patients with delirium the mean duration of in-hospital stay was 4 days longer than control group. Furthermore, delirium was significantly associated with increased BUN/ creatinine ratio, CRP, and BSR values, and with reduced values of arterial blood pressure (both diastolic and systolic), HDL cholesterol, total serum proteins, serum albumin, and serum iron. Conclusions. Our results confirm that in hospitalized elderly patient there is an association between onset of delirium and advanced age, poor functional status. Furthermore this study confirms the association between delirium onset and clinical/laboratory markers of dehydration, systemic inflammation, and malnutrition.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
