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Incidence and impact of delirium on clinical and functional outcomes in older patients hospitalized for acute cardiac diseases

2015; Elsevier BV; Volume: 170; Issue: 5 Linguagem: Inglês

10.1016/j.ahj.2015.08.007

1097-6744

Francisco J. Noriega, María Teresa Vidán, E. Sánchez, Andrea Afonso Díaz, José Antonio Serra Rexach, Francisco Fernández‐Avilés, Héctor Bueno,

Anesthesia and Neurotoxicity Research

Delirium is one of the most frequent complications of hospitalization in elderly patients. Its influence on prognosis in patients admitted for acute cardiac diseases is not well known. The objective of this study is to assess the incidence of delirium and its impact on clinical and functional outcomes in older patients hospitalized for acute cardiac diseases. We prospectively analyzed 203 patients aged 75 years or older admitted to a cardiology unit. Delirium was diagnosed with the Confusion Assessment Method. Logistic regression analysis was used to assess independent predictors of in-hospital delirium and to examine the independent risk of mortality, readmission, functional decline, and need for new help at discharge, at 1 month and 12 months associated with the development of delirium, after adjusting for age, comorbidity, and initial diagnosis. The incidence of delirium was 17.2%. Patients with delirium were older (83 ± 5 vs 81 ± 5 years, P = .016) and showed a higher prevalence of major geriatric syndromes (82.9% vs 54.5%, P = .002). Aggressive ventilation modes, urinary catheters, prolonged fluid therapy, night treatments, longer immobilization, and physical restrain were associated with the incidence of delirium. Patients with delirium presented longer stays (8.9 ± 6.2 vs 6.5 ± 4.0 days, P = .016) and a greater adjusted risk of functional decline at discharge (odds ratio 2.94, 95% CI 1.10-7.86, P = .032) and of 12-month mortality (odds ratio 4.20, 95% CI 1.81-9.74, P = .001). Delirium is a common preventable complication in older patients with acute cardiac diseases. It is associated with poorer in-hospital functional and clinical outcomes, and increased postdischarge mortality.