Korean J Adult Nurs.  2018 Jun;30(3):255-265. 10.7475/kjan.2018.30.3.255.

The Incidence and Related Risk Factors of Delirium in the Older Inpatients with Neurological Disorders in a Tertiary Hospital

• Kim MS
• Jun JY
• Chun HJ
• Kim YO

• KMID: 2414437
• DOI: http://doi.org/10.7475/kjan.2018.30.3.255

Abstract

PURPOSE
Although there is a high incidence of delirium with increased age, the risk factors have been too various. We investigated the incidence and risk factors in the older inpatient with neurological disorders.
METHODS
We reviewed the Electronic Medical Records (EMR) of older patients admitted to a neurology unit from August 2016 to January 2017. We analyzed the incidence and risk factors of delirium in 382 patients in a tertiary hospital. Delirium was determined daily using the Nursing Delirium Screening Scale (Nu-DESC). Demographic, disease, and environmental characteristics were obtained by using structured EMR data.
RESULTS
The incidence rate of delirium was 6.0% (n=23). Delirium was prevalent in patients who were older, had a lower serum hemoglobin, had hypertension or had diabetes mellitus. Delirium was also observed in patients on antibiotics, having a higher number of drugs or catheters, or receiving mechanical monitoring. A longer hospital stay, being admitted to a sub-intensive care unit, and sleep deprivation were significantly associated with delirium. Multiple logistic regression analysis found older age, having sleep deprivation, a higher number of catheters placed, and having diabetes mellitus to be significant predictors of delirium.
CONCLUSION
This study shows that age, sleep deprivation, number of catheters, and comorbidity of diabetes mellitus were identified as a risk factor for delirium. And it will guide the development of algorithms through its possible applications for the future in hospitalized older adults.

MeSH Terms

Adult
Anti-Bacterial Agents
Catheters
Comorbidity
Delirium*
Diabetes Mellitus
Electronic Health Records
Humans
Hypertension
Incidence*
Inpatients*
Length of Stay
Logistic Models
Mass Screening
Nervous System Diseases*
Neurology
Nursing
Risk Factors*
Sleep Deprivation
Tertiary Care Centers*
Anti-Bacterial Agents

Figure

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  Figure 1. Flow diagram of the subject selection.

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