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Risk factors for incident delirium in an acute general medical setting: a retrospective case – control study

Tomlinson, Emily, Phillips, Nicole, Mohebbi, Mohammadreza and Hutchinson, Alison 2017, Risk factors for incident delirium in an acute general medical setting: a retrospective case – control study, Journal of clinical nursing, vol. 26, no. 5-6, pp. 658-667, doi: 10.1111/jocn.13529.

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Title Risk factors for incident delirium in an acute general medical setting: a retrospective case – control study
Author(s) Tomlinson, EmilyORCID iD for Tomlinson, Emily orcid.org/0000-0002-8361-4774
Phillips, NicoleORCID iD for Phillips, Nicole orcid.org/0000-0002-6821-4983
Mohebbi, MohammadrezaORCID iD for Mohebbi, Mohammadreza orcid.org/0000-0001-9713-7211
Hutchinson, AlisonORCID iD for Hutchinson, Alison orcid.org/0000-0001-5065-2726
Journal name Journal of clinical nursing
Volume number 26
Issue number 5-6
Start page 658
End page 667
Total pages 10
Publisher Wiley-Blackwell
Place of publication Chichester, Eng.
Publication date 2017-03
ISSN 1365-2702
Keyword(s) delirium
risk factor
medical patients
acute care
case-control
Science & Technology
Life Sciences & Biomedicine
Nursing
HOSPITALIZED OLDER PATIENTS
INTENSIVE-CARE-UNIT
PRECIPITATING FACTORS
COGNITIVE IMPAIRMENT
INPATIENTS
PATHOPHYSIOLOGY
INTERVENTION
PREVALENCE
PEOPLE
Summary Aims and ObjectivesTo determine predisposing and precipitating risk factors for incident delirium in medical patients during an acute hospital admission.BackgroundIncident delirium is the most common complication of hospital admission for older patients. Up to 30% of hospitalised medical patients experience incident delirium. Determining risk factors for delirium is important for identifying patients that are most susceptible to incident delirium.DesignRetrospective case-control study with two controls per case.MethodsAn audit tool was used to review medical records of patients admitted to acute medical units for data regarding potential risk factors for delirium. Data was collected between August 2013 and March 2014 at three hospital sites of a healthcare organisation in Melbourne, Australia. Cases were 161 patients admitted to an acute medical ward and diagnosed with incident delirium between 1st January 2012 and 31st December 2013. Controls were 321 patients sampled from the acute medical population admitted within the same time range, stratified for admission location and who did not develop incident delirium during hospitalisation.ResultsIdentified using logistic regression modelling, predisposing risk factors for incident delirium were: dementia, cognitive impairment, functional impairment, previous delirium, and fracture on admission. Precipitating risk factors for incident delirium were: use of an indwelling catheter, adding more than three medications during admission and having an abnormal sodium level during admission.ConclusionsMultiple risk factors for incident delirium exist; patients with a history of delirium, dementia and cognitive impairment are at greatest risk of developing delirium during hospitalisation.Relevance to clinical practiceNurses and other health care professionals should be aware of patients that have one or more risk factors for incident delirium. Knowledge of risk factors for delirium has the potential to increase the recognition and understanding of patients who are vulnerable to delirium. Early recognition and prevention of delirium can contribute to improved patients safety and reduction in harm.
Language eng
DOI 10.1111/jocn.13529
Field of Research 111099 Nursing not elsewhere classified
1110 Nursing
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Wiley-Blackwell
Free to Read? No
Free to Read Start Date 2018-04-01
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085661

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