Risk factors of acute confusional syndrome in elderly hospitalized in the Hospital Reina Sofía of Murcia. Retrospective case and controls

Main Article Content

Juan Rodado
Irine Aragon


Acute confusional syndrome, delirium, risk factor, elderly inpatients


Background: Acute confusional syndrome is a current problem of special relevance among elderlypatients admitted to hospital medical services. The determination of its risk factors is an essential process in the development and implementation of programs to prevent this complication. Methods: With the mentioned aim we have carried out this case-control study as an analytical, observational, retrospective and transversal study, whose source population was integrated by 60 patients over age 65 according to inclusion and exclusion criteria and divided into two groups: with and without delirium. Discussion: Our analysis has confirmed the association between these factors and delirium: illness severity; previous history of Delirium (OR 10.6); mental status (OR 7.3); high risk medications (OR 6.9); renal failure (OR 6.5); medication at risk added (OR 6); physical status (OR 5.2); use of neuroleptics (OR5.1); anemia (OR 4.75); sodium alterations (OR 4.5); urinary catheter (OR 3.8); low albumin (OR 3.7); infection (OR 3.1). Conclusion: There is no relationship proved between acute confusional syndrom and the following factors: use of benzodiazepines, aggressive procedures, immobility, old age, dementia, diminished ADL skills, co-morbidity and polypharmacy, even if they have been identified as risk factors in previous studies. Hence, these results should be interpreted with caution.


Download data is not yet available.
Abstract 888 | PDF Downloads 0 HTML Downloads 0 XML Downloads 0


Ahmed S, Leurent B, Sampson E.Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis. Age Ageing. 2014; 43:326–333. DOI http://doi.org/10.1093/ageing/afu022

American Psychriatic Association.Diagnostic and Statistic Manual of Mental Disorders DSM-5. Washington DC: APA; 2013.

American Psychriatic Association. Ganuza A, González-Torres MA, Gaviria M. El Delirium: Una revisión orientada a la práctica clínica. Rev. Asoc. Esp. Neuropsiq. 2012; 32(114):247-259. DOI 10.4321/S0211-57352012000200003

Carrasco M, Villarroel L, Calderón J, Martínez G, Andrade M, González T.Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica. Rev. méd. Chile. 2014; 142(7):826-832. https://scielo.conicyt.cl/scielo.php?script=sci_ar

Curyto KJ, Johnson J, TenHave T, Mossey J, Knott K, Katz IR.Survival of hospitalized elderly patients with delirium. Am J Geriatr Psychiatry. 2001; 9:141-147. DOI 10.1016/j.revmed.2007.04.004

Formiga F, San José A, López-Soto A, Ruiz D, Urrutia A, Duaso E.Prevalencia del delirium en pacientes ingresados por enfermedad médica. Med Clin (Barc). 2007;129:571-573. DOI 10.1093/ageing/afu022.

Gentric A, Le Deun P, Estivin S.Prévention du syndrome confusionnel dans un service de médecine interne gériatrique. Rev Med Interne. 2007; 28(9):589- 593. DOI 10.1016/j.revmed.2007.04.004

González M, Martínez G, Calderon J, Villarroel L, Yuri F, Rojas C, et al.Impact of delirium on shortterm mortality in elderly inpatients: a prospective cohort study. Psychosomatics. 2009; 50(3):234-238. DOI 10.1176/appi.psy.50.3.234

Inouye SK, Charpentier PA.Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA. 1996; 275(11): 852-857. PubMed.

Inouye SK, Foreman MD, Mion LC, Katz KH, Cooney LM.Nurse's recognition of delirim and its symptoms: comparison of nurse and researcher ratings. Arch Intern Med. 2001; 161:2467-2473. PubMed

Inouye SK, Rushing JT, Foreman MD, Palmer RM, Pom- pei P.Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. J Gen Intern Med. 1998; 13(4):234-242. PubMed.

Inouye SK, Viscoli CM, Horwitz RI, Hurst LD, Tinetti ME.A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics. Ann Intern Med. 1993; 119(6): 474-481. PubMed

Kaufman DW, Kelly JP, Rosemberg L, Anderson TE, Mitchell AA.Recent patterns of medication use in the ambulatory adult population in the United States. JAMA. 2002; 287:337-344. PubMed

Lázaro M, Ribera J.Síndrome confusional (delirium) en el anciano. Psicogeriatría. 2009; 1(4):209-221. DOI 10.1093/ageing/afu022

Leslie DL, Zhang Y, Bogardus ST, Holford TR, Leo-Summers LS, Inouye SK.Consequences of preventing delirium in hospitalized older adults on nursing home costs. J Am Geriatr Soc. 2005; 53: 405-409. PubMed

McCusker J, Cole M, Dendukuri N, Belzile E, Primeau F.Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study. CMAJ. 2001; 65(5):575-583. PubMed

Medical Chin YC, Koh GCH, Tay YK, Tan CH, Merchant RA.Underdiagnosis of delirium on admission and prediction of patients who will develop delirium during their inpatient stay: a pilot study. Singapore Med J. 2016; 57(1):18-21 DOI 10.11622/smedj.2016007

Morandi P, Pandharipande M, Trabucchi R, Rozzini G, Mistraletti AC, Trompeo.Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients. Intensive Care Med. 2008; 34:1907-1915 DOI 10.1007/s00134-008-1177-6

O’Keeffe ST, Lavan JN.Predicting delirium in elderly patients: development and validation of a riskstratification
model. Age Ageing. 1996; 25(4): 317-321. PubMed

Pompei P, Foreman M, Rudberg MA, Inouye SK, Braund V, Cassel CK.Delirium in hospitalized older persons: outcomes and predictors. J Am Geriatr Soc. 1994; 42(8):809-815. PubMed

Sepulveda E, Franco JG.Delirium en la versión en español del DSM-5: ¿más confusión? Rev Psiquiatr Salud Ment. 2015; 8:242-243. DOI 10.1016/j.rpsm.2015.05.002

Villalpando-Berumen JM, Pineda-Colorado AM, Palacios P, Reyes-Guerrero J, Villa AR, Gutierrez-RoIncidence of delirium, risk factors, and long-term survival of elderly patients hospitalized in a medical specialty teach- ing hospital in Mexico City. Int Psychogeriatr. 2003; 15:325-336. PubMed

Wakefield BJ.Risk for acute confusion on hospital admission. Clin Nurs Res. 2002; 11:153–72. PubMed

Young J, Murthy L, Westby M, Akunne A, O’Mahony R.Diagnosis, prevention, and management of delirium: summary of NICE guidance BMJ. 2010; 341:c3704. DOI 10.1136/bmj.c3704

Young J, Murthy L, Westby M, Akunne A, O’Mahony R.Valoración del riesgo de delirium en pacientes mayores hospitalizados. Rev Esp Geriatr Gerontol. 2010; 45(5):285–290