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Association of point prevalence diagnosis of delirium on length of stay, 6-month mortality, and level of care on discharge at Waitemata District Health Board, Auckland.
N Z Med J. 2015 Mar 27;128(1411):68-76
Authors: Tan AH, Scott J
Abstract
BACKGROUND: Delirium in hospitalised older persons is common and is correlated with adverse outcomes. Few studies of this have been done in New Zealand. The study aimed to measure the impact of delirium on 6-month mortality, length of inpatient stay and level of care.
METHOD: We performed a retrospective analysis utilising data from the Delirium Point Prevalence Audit conducted at Waitemata District Health Board. The subjects were older inpatients (>65 years) surveyed between 15/05/2012 to 24/07/2012. Delirium was defined as screening positive on the Confusion Assessment Method (CAM). Patients were dichotomised into those with delirium or without.
RESULTS: 250 patients were identified. 28(11.2%) were CAM-positive while 222 (88.8%) were CAM-negative. Mortality at 6 months for the CAM-positive group was 39%, compared to 10% in the CAM-negative group (p<0.005). The mean inpatient day stay for the CAM-positive group was 25.4 days; for the CAM-negative group it was 21.6 days (p=0.721). The proportion requiring an increased level of care at discharge was 66.6% for the CAM-positive group, while for CAM-negative persons the rate was 13.8% (p<0.00003).
CONCLUSION: In hospitalised older adults, the presence of a positive CAM test for delirium was strongly associated with both a higher mortality rate at 6 months and a requirement for an increased level of care at discharge as compared to a negative CAM. No effect was observed on inpatient length of stay.
PMID: 25820505 [PubMed - indexed for MEDLINE]