Prevalence and demographic and clinical characteristics of in-hospital death among older patients with delirium

Abstract

Objective: to estimate the prevalence and investigate demographic and clinical characteristics of in-hospital death in older patients with delirium admitted to a medical clinic ward. Methods: cross-sectional study using data from older patients (≥60 years) with delirium from a public hospital in Barbacena-MG. Delirium was identified using the Confusion Assessment Method (CAM) instrument. Demographic and clinical variables were operationalized as: age group (60‒74/≥75 years), sex (male/female), subtype of delirium (hyperactive/hypoactive/mixed), previous comorbidities (yes/no), medications used to the management of delirium (none/antipsychotics/others) and in-hospital death (yes/no). Data were expressed as relative frequency. The categories of demographic and clinical variables were compared according to in-hospital death using 95% confidence intervals (95% CI). Non-overlap between intervals was considered a significant difference. Results: Data from 52 medical records of older patients were used. The prevalence of in-hospital death was 38.5%. The frequency of deaths was significantly higher in older adults who presented with hyperactive delirium (65.0%, 95% CI = 43.2–82.0% vs 20.0%, 95% CI = 7.5‒42.2% vs 15.0%, 95% CI = 4.4‒36.9%), with previous comorbidities (95.0%, 95% CI = 75.6‒100% vs 5.0%, 95% CI = 0,0‒25.4%) and in those who used antipsychotics (75.0%, 95% CI = 52.8‒89.2% vs 15.0%, 95% CI = 4.4‒36.9% vs 10.0%, 95% CI = 1.6‒31.3%). Conclusion: contrary to what was observed in the literature, there was a higher mortality in the hyperactive subtype. In-hospital healthcare professionals must be attentive to older patients with delirium who present with psychomotor agitation, who have previous comorbidities and who are using antipsychotics.