Clinical characteristics and prognosis for delirium in Spanish internal medicine departments: An analysis from a large clinical-administrative database. / Características clínicas del delirio y sus implicaciones pronósticas en los servicios de medicina interna españoles: análisis de una gran base de datos clínico-administrativa.
Rev Clin Esp (Barc)
; 219(8): 415-423, 2019 Nov.
Article
em En, Es
| MEDLINE
| ID: mdl-31014566
ABSTRACT
OBJECTIVES:
To investigate the prevalence of reported delirium and its associated factors and costs.DESIGN:
Retrospective and descriptive analysis of a national clinical-administrative database that includes all patients hospitalised in Spain in internal medicine departments from January 2007 to December 2014. MATERIAL ANDMETHOD:
The study included the patients' sociodemographic and clinical data (sex, age, diagnosis and procedures).RESULTS:
The prevalence of reported delirium was 2.5% (114,343 of 4,628,397 discharge reports). Delirium was most common in the 81-90-year age group (48%) and in institutionalised patients (4.5% vs. 2.9%; P<.001). The diagnoses most associated with delirium were dementia (14% vs. 7% for patients without delirium), cerebrovascular disease (17% vs. 11%), malnutrition (4% vs. 2%), pressure ulcers (4% vs. 2%), dysphagia (2% vs. 0.2%) and hyponatraemia (5% vs. 2%) (P<.001 in all cases). Patients with delirium also had longer mean stays (11.85±13.15days vs. 9.49±11.17) and higher hospital mortality (OR 1.41; 95%CI 1.39-1.43; P=.0001). The costs attributable to delirium in 8years exceeded 100 million (almost 1,000 per hospitalisation/patient). We developed a predictive model for the risk of developing delirium, which has insufficient sensitivity but is useful for identifying low-risk patients.CONCLUSIONS:
Patients who develop delirium during their hospitalisation in internal medicine have a longer stay, greater mortality and an increased risk of being institutionalised at discharge. Delirium is probably poorly reported in the discharge reports prepared by internists.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
/
Es
Revista:
Rev Clin Esp (Barc)
Ano de publicação:
2019
Tipo de documento:
Article