Hyperactive delirium during emergency department stay
To investigate factors related to the development of hyperactive delirium in patients during emergency department (ED) stay and the association with short-term outcomes. A secondary analysis of the EDEN (Emergency Department and Elderly Needs) multipurpose multicenter cohort was performed. Patients...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universitat Autònoma de Barcelona |
| Repositorio: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglés |
| OAI Identifier: | oai:ddd.uab.cat:300099 |
| Acceso en línea: | https://ddd.uab.cat/record/300099 https://dx.doi.org/urn:doi:10.1007/s11739-023-03440-3 |
| Access Level: | acceso abierto |
| Palabra clave: | Benzodiazepines Delirium Emergency department Mortality Neuroleptics Outcome |
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Hyperactive delirium during emergency department stayanalysis of risk factors and association with short-term outcomesMiró, Oscar|||0000-0002-7924-9751Osorio, Georgina I.Alquézar-Arbé, A.|||0000-0003-4164-274XAguiló, Sira|||0000-0001-9334-1282Fernández Alonso, Cesáreo|||0000-0002-2152-4001Burillo Putze, Guillermo|||0000-0001-5679-7846Jacob, Javier|||0000-0003-1101-1066Llorens Soriano, Pere|||0000-0002-9291-7179Llauger, LluisPeláez González, ÁngelFiguera Castro, Edmundo RamónJuarez-González, RicardoBlanco Hoffman, María JoséFernandez Salgado, FátimaPablos Pizarro, TeresaBerenguer Díez, María AmparoTruyol Más, MarinaLópez-Laguna, Nieves|||0000-0002-2092-0360Garcia Acosta, JacintoFernandez Domato, CarmenDiego Robledo, Francisco JavierEzponda, Patxi|||0000-0003-2595-5009Martinez Lorenzo, AndreaOrtega Liarte, Juan VicenteGarcía Rupérez, InmaculadaBorne Jerez, SetefillaCorugedo Ovies, ClaudiaGallardo Sánchez, Blanca AndreaGonzález del Castillo, JuanBenzodiazepinesDeliriumEmergency departmentMortalityNeurolepticsOutcomeTo investigate factors related to the development of hyperactive delirium in patients during emergency department (ED) stay and the association with short-term outcomes. A secondary analysis of the EDEN (Emergency Department and Elderly Needs) multipurpose multicenter cohort was performed. Patients older than 65 years arriving to the ED in a calm state and who developed confusion and/or psychomotor agitation requiring intravenous/intramuscular treatment during their stay in ED were assigned to delirium group. Patients with psychiatric and epileptic disorders and intracranial hemorrhage were excluded. Thirty-four variables were compared in both groups and outcomes were adjusted for age, sex, Charlson Comorbidity Index, Barthel Index and polypharmacy. Hyperactive delirium that needed treatment were developed in 301 out of 18,730 patients (1.6%). Delirium was directly associated with previous episodes of delirium (OR: 2.44, 95% CI 1.24-4.82), transfer to the ED observation unit (1.62, 1.23-2.15), chronic treatment with opiates (1.51, 1.09-2.09) and length of ED stay longer than 12 h (1.41, 1.02-1.97) and was indirectly associated with chronic kidney disease (0.60, 0.37-0.97). The 30-day all-cause mortality was 4.0% in delirium group and 2.9% in non-delirium group (OR: 1.52, 95% CI 0.83-2.78), need for hospitalization 25.6% and 25% (1.09, 0.83-1.43), in-hospital mortality 16.4% and 7.3% (2.32, 1.24-4.35), prolonged hospitalization 54.5% and 48.6% (1.27, 0.80-2.00), respectively, and 90-day post-discharge combined adverse event 36.4% and 35.8%, respectively (1.06, 0.82-2.00). Patients with previous episodes of delirium, treatment with opioids and longer stay in ED more frequently develop delirium during ED stay and preventive measures should be taken to minimize the incidence. Delirium is associated with in-hospital mortality during the index event.Universitat Autònoma de Barcelona 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/300099https://dx.doi.org/urn:doi:10.1007/s11739-023-03440-3reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3000992026-06-06T12:50:31Z |
| dc.title.none.fl_str_mv |
Hyperactive delirium during emergency department stay analysis of risk factors and association with short-term outcomes |
| title |
Hyperactive delirium during emergency department stay |
| spellingShingle |
Hyperactive delirium during emergency department stay Miró, Oscar|||0000-0002-7924-9751 Benzodiazepines Delirium Emergency department Mortality Neuroleptics Outcome |
| title_short |
Hyperactive delirium during emergency department stay |
| title_full |
Hyperactive delirium during emergency department stay |
| title_fullStr |
Hyperactive delirium during emergency department stay |
| title_full_unstemmed |
Hyperactive delirium during emergency department stay |
| title_sort |
Hyperactive delirium during emergency department stay |
| dc.creator.none.fl_str_mv |
Miró, Oscar|||0000-0002-7924-9751 Osorio, Georgina I. Alquézar-Arbé, A.|||0000-0003-4164-274X Aguiló, Sira|||0000-0001-9334-1282 Fernández Alonso, Cesáreo|||0000-0002-2152-4001 Burillo Putze, Guillermo|||0000-0001-5679-7846 Jacob, Javier|||0000-0003-1101-1066 Llorens Soriano, Pere|||0000-0002-9291-7179 Llauger, Lluis Peláez González, Ángel Figuera Castro, Edmundo Ramón Juarez-González, Ricardo Blanco Hoffman, María José Fernandez Salgado, Fátima Pablos Pizarro, Teresa Berenguer Díez, María Amparo Truyol Más, Marina López-Laguna, Nieves|||0000-0002-2092-0360 Garcia Acosta, Jacinto Fernandez Domato, Carmen Diego Robledo, Francisco Javier Ezponda, Patxi|||0000-0003-2595-5009 Martinez Lorenzo, Andrea Ortega Liarte, Juan Vicente García Rupérez, Inmaculada Borne Jerez, Setefilla Corugedo Ovies, Claudia Gallardo Sánchez, Blanca Andrea González del Castillo, Juan |
| author |
Miró, Oscar|||0000-0002-7924-9751 |
| author_facet |
Miró, Oscar|||0000-0002-7924-9751 Osorio, Georgina I. Alquézar-Arbé, A.|||0000-0003-4164-274X Aguiló, Sira|||0000-0001-9334-1282 Fernández Alonso, Cesáreo|||0000-0002-2152-4001 Burillo Putze, Guillermo|||0000-0001-5679-7846 Jacob, Javier|||0000-0003-1101-1066 Llorens Soriano, Pere|||0000-0002-9291-7179 Llauger, Lluis Peláez González, Ángel Figuera Castro, Edmundo Ramón Juarez-González, Ricardo Blanco Hoffman, María José Fernandez Salgado, Fátima Pablos Pizarro, Teresa Berenguer Díez, María Amparo Truyol Más, Marina López-Laguna, Nieves|||0000-0002-2092-0360 Garcia Acosta, Jacinto Fernandez Domato, Carmen Diego Robledo, Francisco Javier Ezponda, Patxi|||0000-0003-2595-5009 Martinez Lorenzo, Andrea Ortega Liarte, Juan Vicente García Rupérez, Inmaculada Borne Jerez, Setefilla Corugedo Ovies, Claudia Gallardo Sánchez, Blanca Andrea González del Castillo, Juan |
| author_role |
author |
| author2 |
Osorio, Georgina I. Alquézar-Arbé, A.|||0000-0003-4164-274X Aguiló, Sira|||0000-0001-9334-1282 Fernández Alonso, Cesáreo|||0000-0002-2152-4001 Burillo Putze, Guillermo|||0000-0001-5679-7846 Jacob, Javier|||0000-0003-1101-1066 Llorens Soriano, Pere|||0000-0002-9291-7179 Llauger, Lluis Peláez González, Ángel Figuera Castro, Edmundo Ramón Juarez-González, Ricardo Blanco Hoffman, María José Fernandez Salgado, Fátima Pablos Pizarro, Teresa Berenguer Díez, María Amparo Truyol Más, Marina López-Laguna, Nieves|||0000-0002-2092-0360 Garcia Acosta, Jacinto Fernandez Domato, Carmen Diego Robledo, Francisco Javier Ezponda, Patxi|||0000-0003-2595-5009 Martinez Lorenzo, Andrea Ortega Liarte, Juan Vicente García Rupérez, Inmaculada Borne Jerez, Setefilla Corugedo Ovies, Claudia Gallardo Sánchez, Blanca Andrea González del Castillo, Juan |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Universitat Autònoma de Barcelona |
| dc.subject.none.fl_str_mv |
Benzodiazepines Delirium Emergency department Mortality Neuroleptics Outcome |
| topic |
Benzodiazepines Delirium Emergency department Mortality Neuroleptics Outcome |
| description |
To investigate factors related to the development of hyperactive delirium in patients during emergency department (ED) stay and the association with short-term outcomes. A secondary analysis of the EDEN (Emergency Department and Elderly Needs) multipurpose multicenter cohort was performed. Patients older than 65 years arriving to the ED in a calm state and who developed confusion and/or psychomotor agitation requiring intravenous/intramuscular treatment during their stay in ED were assigned to delirium group. Patients with psychiatric and epileptic disorders and intracranial hemorrhage were excluded. Thirty-four variables were compared in both groups and outcomes were adjusted for age, sex, Charlson Comorbidity Index, Barthel Index and polypharmacy. Hyperactive delirium that needed treatment were developed in 301 out of 18,730 patients (1.6%). Delirium was directly associated with previous episodes of delirium (OR: 2.44, 95% CI 1.24-4.82), transfer to the ED observation unit (1.62, 1.23-2.15), chronic treatment with opiates (1.51, 1.09-2.09) and length of ED stay longer than 12 h (1.41, 1.02-1.97) and was indirectly associated with chronic kidney disease (0.60, 0.37-0.97). The 30-day all-cause mortality was 4.0% in delirium group and 2.9% in non-delirium group (OR: 1.52, 95% CI 0.83-2.78), need for hospitalization 25.6% and 25% (1.09, 0.83-1.43), in-hospital mortality 16.4% and 7.3% (2.32, 1.24-4.35), prolonged hospitalization 54.5% and 48.6% (1.27, 0.80-2.00), respectively, and 90-day post-discharge combined adverse event 36.4% and 35.8%, respectively (1.06, 0.82-2.00). Patients with previous episodes of delirium, treatment with opioids and longer stay in ED more frequently develop delirium during ED stay and preventive measures should be taken to minimize the incidence. Delirium is associated with in-hospital mortality during the index event. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2 2023-01-01 2023 2023-01-01 |
| dc.type.none.fl_str_mv |
Article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://ddd.uab.cat/record/300099 https://dx.doi.org/urn:doi:10.1007/s11739-023-03440-3 |
| url |
https://ddd.uab.cat/record/300099 https://dx.doi.org/urn:doi:10.1007/s11739-023-03440-3 |
| dc.language.none.fl_str_mv |
Inglés eng |
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Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/ |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/ |
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openAccess |
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application/pdf |
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reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona |
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