DELIRIUM IN HOSPITALIZED ELDERLY PATIENTS - POLYMORPHISM OF CLINICAL-FEATURES AND OUTCOMES - PROSPECTIVE-STUDY IN 183 CONSECUTIVE PATIENTS

Using explicit criteria contained in the DSM III R we collected in a p rospective cohort study clinical features, outcome and risk factors fr om two cohorts of delirium in hospitalized elderly patients: 138 hospi talized in geriatric department and 45 patients admitted to an acute a nd comprehensive care hospital. The clinical features were assessed us ing a quantitative scale (developed by Derouesne). Delirium was unreco gnized or misdiagnosed by physicians in 34% of the cases. The onset wa s known only two thirds of cases. The incidence of hyperactive type, p rolonged hospital stay, poor outcomes (persistent delirium leading up to dementia) were highest in subjects admitted in comprehensive hospit al The etiology of delirium is complex and multifactorial. An underlyi ng cause was identified in 80% of patients. The length or the worsenin g of delirium was significantly higher in patients with psychiatric or dementia comorbidity (OR: 0.2; IC 95%: 0.1-0.5). The prognosis was be tter in patients without psychoactive medications (OR: 0.2; IC 95%: 0. 1-0.4) or with metabolic abnormalities or acute diseases and disorders (OR: 3.3; IC 95%: 1.5-7.6). The predisposing factors to the developme nt of dementia were prior use of psychoactive medications and signs of prior cognitive impairment. This article suggests delirium in elderly patients is associated with several outcomes. The prognosis should be improved at admission by specific scale and an evaluation of predispo sing and precipitating factors.