Delirium in older COVID-19 patients: Evaluating risk factors and outcomes.

Autor: Kroon B; Department of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands., Beishuizen SJE; Department of Geriatric Medicine, OLVG Hospitals Amsterdam, Amsterdam, The Netherlands., van Rensen IHT; Department of Emergency Medicine, VieCuri Medical Center, Venlo, The Netherlands., Barten DG; Department of Emergency Medicine, VieCuri Medical Center, Venlo, The Netherlands., Mehagnoul-Schipper JJ; Intensive Care Department, VieCuri Medical Center, Venlo, The Netherlands., van der Bol JM; Department of Geriatric Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Ellerbroek JLJ; Department of Geriatric Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Festen J; KBO-PCOB, Nieuwegein, The Netherlands., van de Glind EMM; Department of Geriatric Medicine, Alrijne Hospital, Leiderdorp, The Netherlands., Hempenius L; Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands., van der Jagt M; Intensive Care Department, Erasmus Medical Center, Rotterdam, The Netherlands., Jansen SWM; Department of Geriatric Medicine, Catharina Hospital, Eindhoven, The Netherlands., van der Linden CJM; Department of Geriatric Medicine, Catharina Hospital, Eindhoven, The Netherlands., Mooijaart SP; Department of Gerontology and Geriatrics, LUMC, Leiden, The Netherlands., van Munster BC; Department of Geriatric Medicine, UMCG, Groningen, The Netherlands., Oosterwijk LLE; Department of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands., Smit L; Intensive Care Department, Erasmus Medical Center, Rotterdam, The Netherlands., Urlings-Strop LC; Intensive Care Department, Reinier de Graaf Hospital, Delft, The Netherlands., Willems HC; Department of Internal Medicine and Geriatrics, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Mattace-Raso FUS; Department of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands., Polinder-Bos HA; Department of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: International journal of geriatric psychiatry [Int J Geriatr Psychiatry] 2022 Oct; Vol. 37 (10).
DOI: 10.1002/gps.5810
Abstrakt: Objectives: A high incidence of delirium has been reported in older patients with Coronavirus disease 2019 (COVID-19). We aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID-19. Furthermore, we aimed to study the association of delirium independent of frailty with in-hospital outcomes in older COVID-19 patients.
Methods: This study was performed within the framework of the multi-center COVID-OLD cohort study and included patients aged ≥60 years who were admitted to the general ward because of COVID-19 in the Netherlands between February and May 2020. Data were collected on demographics, co-morbidity, disease severity, and geriatric parameters. Prevalence of delirium during hospital admission was recorded based on delirium screening using the Delirium Observation Screening Scale (DOSS) which was scored three times daily. A DOSS score ≥3 was followed by a delirium assessment by the ward physician In-hospital outcomes included length of stay, discharge destination, and mortality.
Results: A total of 412 patients were included (median age 76, 58% male). Delirium was present in 82 patients. In multivariable analysis, previous episode of delirium (Odds ratio [OR] 8.9 [95% CI 2.3-33.6] p = 0.001), and pre-existent memory problems (OR 7.6 [95% CI 3.1-22.5] p < 0.001) were associated with increased delirium risk. Clinical Frailty Scale was associated with increased delirium risk (OR 1.63 [95%CI 1.40-1.90] p < 0.001) in univariable analysis, but not in multivariable analysis. Patients who developed delirium had a shorter symptom duration and lower levels of C-reactive protein upon presentation, whereas vital parameters did not differ. Patients who developed a delirium had a longer hospital stay and were more often discharged to a nursing home. Delirium was associated with mortality (OR 2.84 [95% CI1.71-4.72] p < 0.001), but not in multivariable analyses.
Conclusions: A previous delirium and pre-existent memory problems were associated with delirium risk in COVID-19. Delirium was not an independent predictor of mortality after adjustment for frailty.
(© 2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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