PMID- 20661879
OWN - NLM
STAT- MEDLINE
DCOM- 20110314
LR  - 20131121
IS  - 1099-1166 (Electronic)
IS  - 0885-6230 (Linking)
VI  - 25
IP  - 10
DP  - 2010 Oct
TI  - Clinical associations of delirium in hospitalized adult patients and the role of 
      on admission presentation.
PG  - 1022-9
LID - 10.1002/gps.2500 [doi]
AB  - OBJECTIVE: To describe clinical associations of delirium in hospitalized patients 
      and relationships to on admission presentation. DESIGN: Retrospective analysis of 
      an administrative hospitalization database 1998-2007. SETTING: Acute care 
      hospitalizations in the New York State (NYS). MEASUREMENTS: Four categories of 
      diagnosis related group (DRG) hospitalizations were extracted from a NYS 
      administrative database: pneumonia, congestive heart failure, urinary 
      tract/kidney infection (UTI), and lower extremity orthopedic surgery (LEOS) DRGs. 
      These hospitalizations were examined for clinical associations with delirium 
      coding both on and after admission. RESULTS: Delirium was coded in 0.8% of the 
      cohort, of which an on admission diagnosis was present in 59%. On admission 
      delirium was strongly associated with dementia (adjusted odds ratio 0, 95%CI 
      5.8-6.3) and with adverse drug effects (ADEs) (adjusted odds ratio 4.6, 95%CI 
      4.3, 5.0). After admission delirium was even more highly associated with ADEs 
      (adjusted odds ratio 22.2, 95%CI 20.7-23.7). The UTI DRG category had the 
      greatest proportion of on admission delirium. However after admission delirium 
      was more common in the LEOS DRG category. Over time, there was a greater increase 
      in delirium proportions in the UTI DRG category, and an overall increase in 
      coding for encephalopathy states (potential alternative delirium descriptors). 
      CONCLUSION: ADEs play an important role in delirium regardless of whether or not 
      it is present on admission. While the finding that most delirium hospitalizations 
      presented on admission suggests that delirium impacts more as a clinical 
      admitting determinant, in-hospital prevention strategies may still have benefit 
      in targeted settings where after admission delirium is more frequent, such as 
      patients with LEOS.
CI  - Copyright (c) 2010 John Wiley & Sons, Ltd.
FAU - Lin, Robert Y
AU  - Lin RY
AD  - Department of Medicine, St Vincent's Hospital-Manhattan-SVCMC, New York, NY, USA. 
      robert_lin@nymc.edu
FAU - Heacock, Laura C
AU  - Heacock LC
FAU - Bhargave, Geeta A
AU  - Bhargave GA
FAU - Fogel, Joyce F
AU  - Fogel JF
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Int J Geriatr Psychiatry
JT  - International journal of geriatric psychiatry
JID - 8710629
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Delirium/diagnosis/*epidemiology
MH  - Drug-Related Side Effects and Adverse Reactions/complications
MH  - Female
MH  - Heart Failure/complications
MH  - Humans
MH  - Lower Extremity/surgery
MH  - Male
MH  - Multivariate Analysis
MH  - New York/epidemiology
MH  - Orthopedics/statistics & numerical data
MH  - Patient Admission/*statistics & numerical data
MH  - Retrospective Studies
MH  - Urologic Diseases/complications
EDAT- 2010/07/28 06:00
MHDA- 2011/03/15 06:00
CRDT- 2010/07/28 06:00
PHST- 2010/07/28 06:00 [entrez]
PHST- 2010/07/28 06:00 [pubmed]
PHST- 2011/03/15 06:00 [medline]
AID - 10.1002/gps.2500 [doi]
PST - ppublish
SO  - Int J Geriatr Psychiatry. 2010 Oct;25(10):1022-9. doi: 10.1002/gps.2500.