Delirium, dementia and in-hospital mortality: the results from the Italian Delirium Day 2016, a national multicenter study.

Italian Study Group on Delirium, A. Morandi, Simona Gabriella Di Santo, Antonella Zambon, Antonio Cherubini, Enrico Mossello, Mario Bo, A. Marengoni, Angelo Bianchetti, Stefano Cappa, Filippo Fimognari, Raffaele Antonelli Incalzi, Pietro Gareri, Francesco Perticone, M. Campanini, Italo Penco, Marco Montorsi, M. Di Bari, M. Trabucchi, Giuseppe Bellelli

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND:
There is little evidence about the prevalence of cognitive disorders and their effect on in-hospital mortality in large multicenter studies. The objectives of the 2016th edition of the "Italian Delirium Day", a large multicenter study on in-hospital older patients, were to assess: 1) the point-prevalence of cognitive impairment/no dementia, dementia, delirium and delirium superimposed on dementia, DSD; and 2) the effect of these conditions on in-hospital mortality.

METHODS:
This multicenter study and included 2037 older patients (aged ≥65 years) admitted to acute medical and surgical wards across 205 acute hospitals. The four cognitive disorders groups were defined with a structured approach including the 4 AT and the presence of a documented diagnosis of dementia. The outcome measure was in hospital mortality, as reported by the researchers involved in the study in each center.

RESULTS:
The mean age was 81.17±7.7 years. Overall, 893 patients (43.8%) had neither delirium, nor dementia nor cognitive impairment, 483 (23.7%) had cognitive impairment/no dementia, 230 (11.3%) dementia alone, 187 (9.2%) delirium alone and 244 (12.0%) DSD. Overall, 99 (4.8%) patients died. Participants with delirium alone (Odds Ratio, O.R. 2.56, 95% Confidence interval, C.I. 1.29-5.09) and those with DSD (OR. 2.60, 95% C.I. 1.39-4.85) had higher mortality risk compared to the reference group of patients with "no cognitive impairment".

CONCLUSIONS:
Delirium and DSD were highly prevalent among older hospitalized patients and significantly increased in-hospital mortality. Clinicians should systematically assess these conditions and recognize them as markers of critical conditions and predictors of imminent death.
Original languageEnglish
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
DOIs
Publication statusE-pub ahead of print - Jul 4 2018

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