P33 | Clinical, social and healthcare aspects of delirium: observational cohort study during ordinary hospitalization

G. Campanaro, E. Martinelli, M.C. De Santis, A. Lo Cricchio, G. Bandini | Reparto di Medicina Sperimentale e Clinica, AOUC, Università degli Studi di Firenze, Italy

Abstract

Premises and Purpose of the study: Delirium is a reversible alteration of the state of consciousness characterized by acute onset and fluctuating cognitive functions. It occurs as a consequence of organic or metabolic disease, use of drugs, overdose or abrupt withdrawal of a substance. Our aim was to evaluate the incidence of delirium in Internal Medicine settings and the association between delirium and predisposing and precipitating factors, some of which modifiable.
Materials and Methods: 157 patients older than 70 years admitted to our Internal Medicine Department were enrolled in the study. Every patient was administered the CAM-ICU test and a social evaluation form obtaining a score indicator of the care network (0-20).
Results: 38 patients (24%) had a positive CAM-ICU test, 26 of which (68%) resulted positive within the first 24h of admission (prevalent delirium), whilst 12 (32%) 24h after admission (incident delirium). The risk factors that resulted statistically independent are: faecal retention, sensory deficit, the addition of ≥3 drugs or anticholinergic drugs, use of antipsychotics and hypernatremia. The average score of the care social indicator was lower in patients with delirium. Delirium was found to have a significant impact in Internal Medicine, with a rate of prevalence 25% in our sample, in accordance with literature data. Nearly a third of the patients with a positive CAM-ICU developed a form of incident delirium, underlining the importance of prevention in avoiding the occurrence of delirium during hospitalization.