TY - JOUR
T1 - The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents
T2 - an explorative analysis from the “Delirium Day 2015”
AU - on behalf of the Italian Study Group on Delirium (ISGoD)
AU - Bo, Mario
AU - Porrino, Paola
AU - Di Santo, Simona G.
AU - Mazzone, Andrea
AU - Cherubini, Antonio
AU - Mossello, Enrico
AU - Bianchetti, Angelo
AU - Musicco, Massimo
AU - Ferrari, Alberto
AU - Ferrara, Nicola
AU - Filippini, Claudia
AU - Trabucchi, Marco
AU - Morandi, Alessandro
AU - Bellelli, Giuseppe
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - 4AT test
KW - Cognition
KW - Delirium
KW - Geriatric assessment
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U2 - 10.1007/s40520-018-0974-1
DO - 10.1007/s40520-018-0974-1
M3 - Article
AN - SCOPUS:85047952148
SP - 1
EP - 10
JO - Aging clinical and experimental research
JF - Aging clinical and experimental research
SN - 1594-0667
ER -