Risk of Poor Outcomes Up for Seniors With Delirium in Hospital

Seniors who experience delirium are at increased risk for death, institutionalization, and dementia
By Jeff Muise
HealthDay Reporter

TUESDAY, July 27 (HealthDay News) -- Seniors who experience delirium during hospitalization are at elevated risk for death, eventual institutionalization, and dementia, according to a meta-analysis published in the July 28 issue of the Journal of the American Medical Association.

Joost Witlox, of Medical Center Alkmaar in the Netherlands, and colleagues reviewed the medical literature over the past three decades for studies on elderly patients with delirium that included data on mortality, institutionalization, or dementia after a minimum three-month follow-up. Of 2,939 articles screened, 51 high-quality studies with statistical control for age, sex, comorbid illness or illness severity, and baseline dementia were identified.

Analysis of the pooled data from seven studies involving 714 patients with delirium and 2,243 controls followed for 22.7 months showed that delirium was associated with almost twice the risk of death compared to controls (hazard ratio, 1.95). Analysis of data from another grouping of seven studies involving 527 patients with delirium and 2,052 controls followed for 14.6 months found that patients with delirium were more than twice as likely to be institutionalized (odds ratio, 2.41). Finally, in two combined studies involving 56 patients with delirium and 185 controls followed over 4.1 years, patients with delirium were found to have an increased risk of dementia (odds ratio, 12.52).

"This meta-analysis provides evidence that delirium in elderly patients is associated with poor outcome independent of important confounders, such as age, sex, comorbid illness or illness severity, and baseline dementia," the authors write.

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