TY - JOUR
T1 - Comparison of hospital course and outcome in hospital-acquired vs pre-existing delirium
AU - Guillory, Joseph
AU - Fitz-Gerald, Cecilia
AU - Banik, Antara
AU - Sterwald, Christopher
AU - Ashiofu, Evelyn
AU - Knox, Eleanore
AU - Muyco, Mary Antoinette
AU - Verlage, Megan
AU - Abdali, Arqam
AU - O'Malley, Patrick W.
AU - Rezai, Amelia
AU - Bush, Paul
AU - Brown, E. Sherwood
AU - North, Carol S
N1 - Publisher Copyright:
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PY - 2021/2
Y1 - 2021/2
N2 - BACKGROUND: Delirium is a major source of morbidity in the inpatient hospital setting. This study examined differences between patients with delirium present prior to hospital admission and those with hospital-acquired delirium in several health outcomes. METHODS: A total of 12,529 patients on 2 inpatient units were included in this retrospective cohort study. Outcomes were assessed using chart review. Other variables were compared across groups and included in multivariate models predicting discharge location within the hospital-acquired delirium group. RESULTS: Of 709 patients with delirium, 83% had pre-admission prevalent and 17% had post-admission incident delirium. Compared with patients with preexisting delirium, patients with hospital-acquired delirium had greater hospital durations and mortality and were more likely to receive ICU care, more likely to receive multiple classes of medications, and less likely to be discharged home without home health services. Multivariate analysis in the hospital-acquired delirium group found that several variables independently predicted discharge location. CONCLUSIONS: Patients with hospital-acquired delirium had worse hospital outcomes and a more complicated hospital course than those with preexisting delirium. Administration of various medications, several demographic variables, and some hospital-related variables were independently associated with worse outcomes within the hospital-acquired delirium group. These results demonstrate that patients with hospital-acquired delirium are a vulnerable subgroup deserving special attention.
AB - BACKGROUND: Delirium is a major source of morbidity in the inpatient hospital setting. This study examined differences between patients with delirium present prior to hospital admission and those with hospital-acquired delirium in several health outcomes. METHODS: A total of 12,529 patients on 2 inpatient units were included in this retrospective cohort study. Outcomes were assessed using chart review. Other variables were compared across groups and included in multivariate models predicting discharge location within the hospital-acquired delirium group. RESULTS: Of 709 patients with delirium, 83% had pre-admission prevalent and 17% had post-admission incident delirium. Compared with patients with preexisting delirium, patients with hospital-acquired delirium had greater hospital durations and mortality and were more likely to receive ICU care, more likely to receive multiple classes of medications, and less likely to be discharged home without home health services. Multivariate analysis in the hospital-acquired delirium group found that several variables independently predicted discharge location. CONCLUSIONS: Patients with hospital-acquired delirium had worse hospital outcomes and a more complicated hospital course than those with preexisting delirium. Administration of various medications, several demographic variables, and some hospital-related variables were independently associated with worse outcomes within the hospital-acquired delirium group. These results demonstrate that patients with hospital-acquired delirium are a vulnerable subgroup deserving special attention.
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U2 - 10.12788/acp.0021
DO - 10.12788/acp.0021
M3 - Article
C2 - 33529286
AN - SCOPUS:85100822815
SN - 1040-1237
VL - 33
SP - 35
EP - 44
JO - Annals of Clinical Psychiatry
JF - Annals of Clinical Psychiatry
IS - 1
ER -