Discharge Destinations of Delirious Patients: Findings From a Prospective Cohort Study of 27,026 Patients From a Large Health Care System.
Carl M Zipser, Tobias R Spiller, Florian F Hildenbrand and 5 others
PMID 35172165WHAT IT FOUND
Delirious patients were less likely to go home and more likely to be discharged to a nursing home, acute rehabilitation, another hospital, or die.
Key findings
01Delirious patients were less likely to return home, and this was seen across surgical, medical, and high-acuity wards.
02Delirious patients were more likely to be transferred to another hospital, enter a nursing home, enter acute rehabilitation, or die in hospital.
0331.8% of delirious patients discharged into a nursing home had initially been admitted from home.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Single center in Switzerland, so discharge pathways and available beds may not match other systems. It is observational, so it cannot show that delirium caused the worse destinations or deaths; underlying illness may explain both. The delirium diagnosis used a composite of three screening tools that was not formally validated, and DSM-IV and DSM-5 criteria were treated as equivalent. Subsyndromal delirium was not assessed. There was no follow-up after discharge, so temporary nursing home stays or later deaths were not captured. Many patients were excluded from the original project, and the hospital already had routine screening and management protocols, so results may not apply everywhere.
Declared interests
The supplied metadata lists research support from NIH extramural and non-U.S. government sources. The article text does not provide an author conflict-of-interest declaration or funding statement.
The easy way to misread this
Do not read the odds ratios as proof that delirium caused a worse discharge destination or death. The study was observational and did not test a prevention or treatment program. It only shows that patients who had delirium were more likely to have dependent discharge destinations or die in hospital.