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Does delirium increase hospital stay?
Jane McCusker1, Martin G Cole, Nandini Dendukuri
1Departments of Clinical Epidemiology and Community Studies Psychiatry, St Mary's Hospital, Montreal, Quebec. jane.mccusker@mcgill.ca
Journal of the American Geriatrics Society
|December 23, 2003
Summary
Incident delirium significantly increases hospital stay in older patients by over 7 days. Prevalent delirium, however, does not impact length of stay. Preventing incident delirium may shorten hospitalizations.
Area of Science:
- Geriatric Medicine
- Hospital Medicine
- Cognitive Neurology
Background:
- Delirium is a common complication in older medical inpatients.
- The impact of prevalent versus incident delirium on hospital length of stay (LOS) requires further clarification.
Purpose of the Study:
- To investigate the differential effects of prevalent and incident delirium on hospital length of stay in elderly medical patients.
Main Methods:
- Prospective cohort study involving medical admissions of patients aged 65+.
- Delirium diagnosed using the Confusion Assessment Method (CAM).
- Compared LOS in prevalent delirium, incident delirium, and no delirium groups, controlling for covariates.
Main Results:
- Incident delirium was associated with an excess hospital stay of 7.78 days post-diagnosis (95% CI: 3.07, 12.48).
- Prevalent delirium showed no significant association with increased LOS.
- Results were consistent across different analytical methods, including DRG-adjusted LOS.
Conclusions:
- Incident delirium, not prevalent delirium, is a significant predictor of prolonged hospital stay in older medical inpatients.
- Targeted interventions aimed at preventing incident delirium could potentially reduce overall hospital length of stay.