|
J Am Geriatr Soc. 2001 Oct;49(10):1327-34.
Environmental risk factors for delirium in hospitalized
older people.
McCusker J, Cole M, Abrahamowicz M, Han L, Podoba JE, Ramman-Haddad
L.
Department of Clinical Epidemiology and Community Studies, St.
Mary's Hospital, Montreal, Quebec, Canada.
OBJECTIVES: To evaluate the relationship of environmental
risk factors in hospitals to changes over time in delirium
symptom severity scores. DESIGN: Observational prospective
clinical study with repeated measurements, several times during
the first week of hospitalization and then weekly during
hospitalization. SETTING: University-affiliated general
community hospital. PARTICIPANTS: Four hundred forty-four
patients age 65 and older admitted to the medical wards: 326
with delirium and 118 without delirium. Patients with prior
cognitive impairment were oversampled. MEASUREMENTS: The
severity of delirium symptoms was measured with the Delirium
Index, a scale developed and validated by our group, based on
the Confusion Assessment Method. Potential environmental risk
factors assessed included isolation, hospital unit, room
changes, levels of sensory stimulation, aids to orientation, and
presence of medical (e.g., intravenous) or physical restraints.
RESULTS: Controlling for initial severity of delirium and
patient characteristics, variables significantly related to an
increase in delirium severity scores included hospital unit
(intensive care or long-term care unit), number of room changes,
absence of a clock or watch, absence of reading glasses,
presence of a family member, and presence of medical or physical
restraints. CONCLUSION: The associations of intensive care and
medical and physical restraints with severity of delirium
symptoms may be due to uncontrolled confounding by indication.
However, the other factors identified suggest potentially
modifiable risk factors for symptoms of delirium in hospitalized
older people.
PMID: 11890491 [PubMed - indexed for MEDLINE]
Return
to Roundtables
|
