Hospital admission and the occurrence of delirium in older adults with physical frailty: cross-sectional study.
João Alberto Martins Rodrigues, Maria Helena Lenardt, Clovis Cechinel and 3 others
PMID 38100603WHAT IT FOUND
Among 320 hospitalized older adults, 21.1% had delirium in the first 48 hours.
Most were frail. Delirium was also seen with age over 80 years, dementia, epilepsy, stroke, and increased CRP.
Key findings
0121.1% of 320 hospitalized older adults were diagnosed with delirium within the first 48 hours of admission.
02Of those diagnosed with delirium, 71.6% were frail and 28.3% were pre-frail.
03Delirium was associated with age over 80 years, epilepsy, dementia, stroke, and increased CRP values.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional study, so it cannot show that hospitalization or frailty caused delirium. It was done in one public hospital in southern Brazil, so the results may not apply to other settings. The study excluded people who were critically ill, needed non-invasive ventilation, were near death, hypotensive, awaiting ICU transfer, or isolated. For 146 older adults, companions answered the questionnaire questions, so the delirium information was not always from the patient. The authors said the physical activity instrument contains questions about activities unusual in Brazil and may affect measurement of energy expenditure. The sample size calculation assumed 30% delirium prevalence, but 21.1% was observed in the first 48 hours.
The easy way to misread this
Do not conclude that frailty causes delirium or that screening will prevent it. This was a cross-sectional study from one hospital, and it reported associations within the first 48 hours, not a tested intervention or cause.