Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomes

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...

Descripción completa

Detalles Bibliográficos
Autores: the researchers of the SIESTA network, Paderme-Díaz, Beatriz
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universidad de Málaga
Repositorio:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
Idioma:inglés
OAI Identifier:oai:ddfv.ufv.es:10641/6430
Acceso en línea:https://hdl.handle.net/10641/6430
Access Level:acceso abierto
Palabra clave:Benzodiazepines
Delirium
Emergency department
Mortality
Neuroleptics
Outcome
Internal Medicine
Emergency Medicine
Multicenter Study
Journal Article
Yes
yes
id ES_e261c2bd6845bb90ba4a2c48d656d65c
oai_identifier_str oai:ddfv.ufv.es:10641/6430
network_acronym_str ES
network_name_str España
repository_id_str
spelling Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomesthe researchers of the SIESTA networkPaderme-Díaz, BeatrizBenzodiazepinesDeliriumEmergency departmentMortalityNeurolepticsOutcomeInternal MedicineEmergency MedicineMulticenter StudyJournal ArticleYesyesTo 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.Facultad de Medicina20242024-03-0120242024-03-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10641/6430reponame:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoriainstname:Universidad de MálagaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddfv.ufv.es:10641/64302026-06-11T12:44:57Z
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 : analysis of risk factors and association with short-term outcomes
spellingShingle Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomes
the researchers of the SIESTA network
Benzodiazepines
Delirium
Emergency department
Mortality
Neuroleptics
Outcome
Internal Medicine
Emergency Medicine
Multicenter Study
Journal Article
Yes
yes
title_short Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomes
title_full Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomes
title_fullStr Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomes
title_full_unstemmed Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomes
title_sort Hyperactive delirium during emergency department stay : analysis of risk factors and association with short-term outcomes
dc.creator.none.fl_str_mv the researchers of the SIESTA network
Paderme-Díaz, Beatriz
author the researchers of the SIESTA network
author_facet the researchers of the SIESTA network
Paderme-Díaz, Beatriz
author_role author
author2 Paderme-Díaz, Beatriz
author2_role author
dc.contributor.none.fl_str_mv Facultad de Medicina
dc.subject.none.fl_str_mv Benzodiazepines
Delirium
Emergency department
Mortality
Neuroleptics
Outcome
Internal Medicine
Emergency Medicine
Multicenter Study
Journal Article
Yes
yes
topic Benzodiazepines
Delirium
Emergency department
Mortality
Neuroleptics
Outcome
Internal Medicine
Emergency Medicine
Multicenter Study
Journal Article
Yes
yes
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 2024
dc.date.none.fl_str_mv 2024
2024-03-01
2024
2024-03-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10641/6430
url https://hdl.handle.net/10641/6430
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
instname:Universidad de Málaga
instname_str Universidad de Málaga
reponame_str DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
collection DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869422380789530624
score 15,812455

Similares en LA Referencia