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Delirium heightens death risk in elderly patients

Friday, July 30, 2010, 22:01 This news item was posted in health category and has 0 Comments so far.

Delirium in the elderly patients increases their death risk, says a study.

Dutch researchers reached this conclusion after a review of 51 relevant articles which dealt with the subject of delirium. 

Delirium is a syndrome of acutely altered mental status characterized by inattention and a fluctuating course. With occurrence rates of up to half of older patients postoperatively, and even higher in elderly patients admitted to intensive care units, delirium is the most common complication in hospitalized older people, according to researchers of the Medical Center Alkmaar, the Netherlands.

Joost Witlox, M.Sc and colleagues conducted an analysis of previous studies to assess the association between delirium and long-term poor outcomes in elderly patients while controlling for important other factors that can influence outcomes.

Their primary analyses included only high-quality studies with statistical control for age, sex, co-existing illness or illness severity, and baseline dementia.

The meta analysis of research data found that delirium in elderly patients is associated with an increased risk of death, dementia, and institutionalization, independent of age, co-existing illnesses or illness severity.

Delirium is associated with long-term poor outcome but delirium often occurs in individuals with more severe underlying disease. Moreover, patients who had experienced delirium were also at increased risk of institutionalization and dementia, evidence suggested.

“The results of this meta-analysis provide evidence that delirium in elderly patients is associated with an increased risk, of death, institutionalization, and dementia, independent of age, sex, co morbid illness or illness severity, and presence of dementia at baseline. Moreover, our stratified models confirm that this association persists when excluding studies that included in-hospital deaths and patients residing in an institution at baseline,” the researchers wrote in their study published in the July 28 issue of JAMA.

The Alkmaar researchers believe that the results of this meta-analysis can be instrumental in patient care. “The low rate of survival and the high rates of institutionalization and dementia indicate that older people who experience delirium should be considered an especially vulnerable population.”

Future studies will have to establish what exact mechanisms are responsible for the long-term poor outcomes after delirium and whether clinical characteristics of delirium itself differentially influence prognosis.

Clinical trials are needed to investigate whether the long-term sequelae associated with delirium can be averted, the opined.

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