Relationship Between Delirium and Co-morbidity in Acutely Hospitalized Older Medical Patients

Introduction

• Delirium is common in hospitalized older patients. It is associated with increased mortality, poorer functional outcomes and increased length of stay.
• It has also been shown to be positively associated with level of co-morbidity in older postoperative patients.
• The aims of the study is to assess the correlation between delirium and co-morbidity in older medical inpatients. It also aim to determine the effect of gender on this association.

Method:

• This was a prospective, cross-sectional analysis carried out as part of a Quality Improvement Project on screening for delirium in older patients admitted acutely on medical wards from 6th to 12th October 2022.
• Patients were included if they were 65 years and over.
• Exclusion criteria were patients younger than 65 years. Patients with incomplete data were also excluded from analysis.
• Patients were screened for delirium using the 4-AT screening tool which is well validated.
• In addition the patients’ co-morbidities were assessed using the age-adjusted Charlson’s Comorbidity Index(CCI).
• The SPSS 29 IBM software was used for statistical analysis. Baseline characteristics were calculated using descriptive statistics. Pearson’s correlation co-efficient and linear regression analysis were used to calculate correlation.

Results:

• 233 patients in total were assessed - 119 males and 114 females.
• Median age was 79.4 years in males (Interquartile range – IQR – 11) and 83.5 years in females (interquartile range – IQR – 12).
• Overall mean age was 81.6 years (SD 8.1).
• The prevalence of likely delirium was 32.2 %.
• There was a statistically significant positive correlation between 4-AT and CCI  (r=0.236; p<0.001).
• This effect was stronger in male than female patients (r=0.275, p=0.002 vs r=0.197;p=0.035 ; respectively).

Conclusion:

• There was a statistically significant positive correlation between elevated 4AT score and CCI in acutely hospitalized older medical patients. This correlation was stronger in males.

  • The association needs more studies to validate these findings.