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Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study
Ist Teil von
Aging clinical and experimental research, 2022-08, Vol.34 (8), p.1827-1835
Ort / Verlag
Cham: Springer International Publishing
Erscheinungsjahr
2022
Quelle
SpringerLink (Online service)
Beschreibungen/Notizen
Background
Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation.
Aim
We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the “Delirium Day project”.
Methods
We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the “Delirium Day project” (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale.
Results
Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%).
In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17–1.9,
p
value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08–2.32,
p
value 0.018), dementia (PR 2.10, 95%CI: 1.62–2.73,
p
value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10–1.95,
p
value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02–1.66,
p
value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68–3.36,
p
value < 0.0001).
Conclusion
This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.