Severity and course of delirium in medically hospitalized nursing facility residents

Delirium is a common and serious complication of medical illness in frail elderly patients. The authors report on a series of nursing facility delirium patients followed for 3 months during and after acute medical hospitalization. Delirium was persistent to time of death or hospital discharge in 72%. At 1 and 3 months, 55% and 25%, respectively, showed delirium. Mortality rate was high, with in-hospital and 3-month mortality rates of 18% and 47%, respectively. More severe delirium and failure to improve delirium while in the hospital were both associated with increased mortality. A purely hypoactive delirium vs. a hyperactive or mixed was associated with delirium persistence. Delirium is associated with high mortality and frequent persistence. Additional research is needed to clarify who is at risk for delirium with associated persistence and/or mortality.