Risk factors for delirium – characteristics of patients at risk of delirium in Geriatric Ward

Background. Delirium is an acute cognitive disorder comorbid with impaired consciousness and psychomotor activity. It occurs in 30–50% of patients in geriatric wards. It is the most common and least recognized syndrome in geriatrics.

Objectives. The aim of the study was to formulate the characteristics of the patient’s risk of developing delirium in the Geriatric Ward.

Material and methods. The study included all patients admitted to the Ward from 15 June 2013 until 15 June 2014 (n = 788). In 5% (n = 41) diagnosed symptoms of delirium. Assessment of the need for care – by Barthel, independence by IADL, the pain

by VAS or DOLOPLUS, mental status by MMSE, the risk of falling by the “get up and go” test, occurrence of delirium by CAM, depth of delirium by DOM, agitation-sedation by RASS.

Results. In the group with symptoms of delirium (n = 41) there were 76% (n = 31) female and 24% (n = 10) male. In 90% (n = 37) the mobility was impaired. By the Barthel 41% (n = 20) had ≤ 40 points, by IADL 78% (n = 32) had ≤ 16 points. 85% (n = 35) has high risk of falling. By VAS 71% (n = 26), (n = 36) – ≥ 4 points, the pain by DOLOPLUS – 16.7 points (15% of the group (n = 5)). By MMSE 66% (n = 27) had ≤ 18 points. Delirium in an interview – 61% (n = 24). 61% (n = 26) had used ≥ 5 drugs. Incontinence – 56% (n = 25), bladder catheterization – 27% (n = 11). 83% (n = 34) had ≥ 10 risk factors for delirium.

Conclusions. The patient at risk of delirium is the patient with concomitant: dementia, delirium in the past, urinary incontinence, limited mobility and pain, patients taking drugs ≥ 5, involving ≥ 10 risk factors for delirium.