The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the "Delirium Day 2015".
Aging Clin Exp Res
; 31(3): 411-420, 2019 Mar.
Article
in En
| MEDLINE
| ID: mdl-29858986
ABSTRACT
BACKROUND Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. AIM:
This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients.METHODS:
Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4 possible delirium; scores 1-3 possible cognitive impairment).RESULTS:
Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia.DISCUSSION:
We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents.CONCLUSION:
Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Urinary Catheterization
/
Catheters, Indwelling
/
Delirium
/
Nursing Homes
Type of study:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
En
Journal:
Aging Clin Exp Res
Journal subject:
GERIATRIA
Year:
2019
Document type:
Article
Affiliation country:
Italy