Background
Methods
Design
Outcome
Main exposures
Delirium
Covariates
Data analysis
Results
Study population
Variables n (%), m (sd), median (IQR) | Total | CAM delirium status | p value* | ||
---|---|---|---|---|---|
FSD | SSD | No delirium | |||
n, (%) | 610 (100) | 69 (11) | 202 (33) | 339 (56) | |
Demographics | |||||
Gender, (%) | |||||
Male | 251 (41) | 24 (10) | 70 (28) | 157 (62) | 0.015* |
Female | 359 (59) | 45 (12) | 132 (37) | 182 (51) | |
Age in years, (%) | |||||
70–79 | 227 (37) | 13 (6) | 63 (28) | 151 (66) | < 0.001* |
80–89 | 265 (44) | 35 (13) | 85 (32) | 145 (55) | |
90+ | 118 (19) | 21 (18) | 54 (46) | 43 (36) | |
Type of residence, (%) | |||||
House | 434 (71) | 31 (7) | 122 (28) | 281 (65) | < 0.001* |
Residential | 46 (8) | 4 (9) | 12 (26) | 30 (65) | |
Nursing home | 42 (7) | 12 (29) | 20 (48) | 10 (24) | |
Sheltered | 88 (14) | 22 (25) | 48 (55) | 18 (20) | |
Ethnicity, (%) | |||||
White | 428 (70) | 11 (12) | 144 (34) | 234 (55) | 0.816 |
Marital status, (%) | |||||
Married | 198 (33) | 15 (8) | 58 (29) | 125 (63) | 0.096 |
Single | 87 (14) | 8 (9) | 30 (35) | 49 (56) | |
Widowed | 282 (46) | 40 (14) | 101 (36) | 141 (50) | |
Divorced | 36 (6) | 4 (11) | 10 (28) | 22 (61) | |
Unknown | 7 (1) | 2 (28) | 3 (43) | 2 (29) | |
Smoking status, (%) | |||||
Never | 281 (46) | 40 (14) | 105 (37) | 136 (48) | < 0.001* |
Ex | 269 (44) | 22 (8) | 83 (31) | 164 (61) | |
Current | 55 (9) | 4 (7) | 13 (24) | 38 (69) | |
Unknown | 5 (1) | 3 (60) | 1 (20) | 1 (20) | |
Clinical Characteristics | |||||
Presence of CAM individual item acute onset, (%)a | 99 (17) | 69 (100) | 30 (15) | 0 (0) | < 0.001* |
Presence of CAM individual item inattention, (%)a | 108 (19) | 69 (100) | 39 (19) | 0 (0) | < 0.001* |
Presence of CAM individual item disorganized thinking, (%)a | 97 (17) | 65 (94) | 32 (16) | 0 (0) | < 0.001* |
Presence of CAM individual item, altered level of consciousness, (%)a | 99 (17) | 63 (91) | 36 (19) | 0 (0) | < 0.001* |
Psychiatric history admissions, (%)a | |||||
None known | 483 (80) | 47 (10) | 149 (31) | 287 (59) | 0.047* |
Anxiety | 6 (1) | 0 (0) | 3 (50) | 3 (50) | |
Depression and anxiety | 12 (2) | 2 (17) | 5 (42) | 5 (42) | |
Depression | 86 (14) | 17 (20) | 37 (43) | 32 (37) | |
Alcohol | 9 (1) | 1 (11) | 4 (44) | 4 (44) | |
Bipolar | 3 (1) | 0 (0) | 1 (33) | 2 (67) | |
Psychosis | 8 (1) | 2 (25) | 3 (37) | 3 (38) | |
Dementia status, (%) | |||||
Yes | 159 (26) | 45 (28) | 84 (53) | 30 (19) | < 0.001* |
No | 451 (74) | 24 (5) | 118 (26) | 309 (69) | |
Functional Assessment Staging Score, (%) | |||||
1. No functional impairment | 263 (43) | 3 (1) | 35 (13) | 225 (86) | < 0.001* |
2–5. Subjective functional deficit, objective functional deficit, difficulties with activities of daily living | 179 (29) | 13 (7) | 74 (41) | 92 (51) | |
6a–c. Help required getting dressed, toileting or personal hygiene | 66 (11) | 24 (36) | 29 (44) | 13 (20) | |
6d–e. Double incontinence | 62 (10) | 20 (32) | 36 (58) | 6 (10) | |
7a–f. Speaks limited vocabulary, can no longer walk, sit up, hold up head | 40 (7) | 9 (23) | 28 (70) | 3 (7) | |
Waterlow score, mean (sd)a N = 605 | 13 (6) | 17 (7) | 15 (7) | 11 (5) | < 0.001* |
Incontinence, (%)a | |||||
None | 460 (75) | 32 (7) | 120 (26) | 308 (67) | < 0.001* |
Urine | 58 (10) | 14 (24) | 28 (48) | 16 (28) | |
ICD on admission | 16 (3) | 4 (25) | 6 (38) | 6 (37) | |
Double | 75 (12) | 19 (25) | 48 (64) | 8 (11) | |
Pressure sores, (%) | |||||
Yes | 58 (10) | 14 (24) | 36 (62) | 8 (14) | < 0.001* |
No | 551 (90) | 55 (10) | 166 (30) | 330 (60) | |
Unknown | 1 (0) | 0 (0) | 0 (0) | 1 (100) | |
Charlson Comorbidity Index score, median (IQR) | 2 (3) | 3 (2) | 3 (2) | 2 (3) | 0.067 |
APACHE II score, median (IQR)aN = 593 | 11 (4) | 14 (5) | 12 (4) | 11 (4) | < 0.001* |
Commonest diagnosis on admission, (%) | |||||
ACS | 56 (9) | 3 (5) | 10 (18) | 43 (77) | < 0.001* |
COPD | 37 (6) | 2 (5) | 9 (24) | 26 (70) | |
UTI | 54 (9) | 11 (20) | 24 (44) | 19 (35) | |
Pneumonia | 91 (15) | 20 (22) | 42 (46) | 29 (32) | |
Other | 372 (61) | 33 (9) | 117 (31) | 222 (60) | |
Length of admission, median (IQR)a N = 609 | 8 (13) | 14 (20) | 9 (13) | 7 (10) | < 0.001* |
Survival time – days, median (IQR)a N = 357 | 157 (457) | 125 (355) | 143 (454) | 194 (495) | 0.022* |
Delirium status | |||
---|---|---|---|
Full delirium n = 56 | Subsyndromal delirium n = 122 | No delirium n = 179 | |
Survival time% | |||
<6 months | 62.50 (0.49, 0.76) | 54.92 (0.46, 0.64) | 49.72 (0.42, 0.57) |
>6 months | 37.50 (0.24, 0.51) | 45.08 (0.36, 0.54) | 50.28 (0.43, 0.58) |
Median survival time (months) | 5.03 (2.30, 13.93) | 21.16 (13.11, 29.04) | 31.21 (23.66, NA) |
HR (95% CI) p-value. | ||||||
---|---|---|---|---|---|---|
None (unadjusted)
| +Age | + Gender | + CCI | + Waterlow | + APACHE II | |
Delirium key core symptoms | ||||||
Acute onset (n = 583) | 1.88 | 1.80 | 1.80 | 1.76 | 1.46 | 1.41 |
(1.45, 2.42) | (1.39, 2.33) | (1.39, 2.33) | (1.35, 2.29) | (1.11, 1.91) | (1.07, 1.86) | |
p < 0.001* | p < 0.001* | p < 0.001* | p < 0.001* | p = 0.007* | p = 0.016* | |
Inattention (n = 576) | 1.80 | 1.74 | 1.75 | 1.73 | 1.33 | 1.24 |
(1.40, 2.32) | (1.35, 2.25) | (1.36, 2.26) | (1.34, 2.24) | (1.01, 1.77) | (0.92, 1.67) | |
p < 0.001* | p < 0.001* | p < 0.001* | p < 0.001* | p = 0.044* | p = 0.152 | |
Disorganised thinking (n = 563) | 2.06 | 1.97 | 2.01 | 1.94 | 1.52 | 1.42 |
(1.59, 2.67) | (1.51, 2.55) | (1.54, 2.54) | (1,48, 2.54) | (1.14, 2.04) | (1.05, 1.92) | |
p < 0.001* | p < 0.001* | p < 0.001* | p < 0.001* | p = 0.005* | p = 0.024* | |
Altered level of consciousness (n = 588) | 2.04 | 1.95 | 1.96 | 1.82 | 1.41 | 1.33 |
(1.58, 2.63) | (1.50, 2.52) | (1.51, 2.53) | (1.40, 2.37) | (1.06, 1.88) | (0.98, 1.79) | |
p < 0.001* | p < 0.001* | p < 0.001* | p < 0.001* | p = 0.018* | p = 0.063 |