The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the "Delirium Day 2015"

Italian Study Group on Delirium (ISGoD)

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalAging clinical and experimental research
DOIs
Publication statusE-pub ahead of print - Jun 1 2018

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Urinary Catheters
Indwelling Catheters
Delirium
Nursing Homes
Dementia
Geriatric Assessment
Aphasia
Coma
Informed Consent
Multicenter Studies
Cross-Sectional Studies
Logistic Models
Regression Analysis

Cite this

@article{6f59df2e765a40c38210070c99bfd1b5,
title = "The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the {"}Delirium Day 2015{"}",
abstract = "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.",
author = "{Italian Study Group on Delirium (ISGoD)} and Mario Bo and Paola Porrino and {Di Santo}, {Simona G} and Andrea Mazzone and Antonio Cherubini and Enrico Mossello and Angelo Bianchetti and Massimo Musicco and Alberto Ferrari and Nicola Ferrara and Claudia Filippini and Marco Trabucchi and Alessandro Morandi and Giuseppe Bellelli",
year = "2018",
month = "6",
day = "1",
doi = "10.1007/s40520-018-0974-1",
language = "English",
journal = "Aging clinical and experimental research",
issn = "1594-0667",
publisher = "Springer International Publishing AG",

}

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 - 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 - 2018/6/1

Y1 - 2018/6/1

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.

U2 - 10.1007/s40520-018-0974-1

DO - 10.1007/s40520-018-0974-1

M3 - Article

C2 - 29858986

JO - Aging clinical and experimental research

JF - Aging clinical and experimental research

SN - 1594-0667

ER -