Objective: Delirium as a geriatric emergency is a disease commonly observed in elderly people. The reason of delirium is multifactorial and psychiatric disorders such as depression and alcoholism, psychoactive medicine usage, advanced age, poly-pharmacy, surgery, infections, exacerbation of present comorbid disease, hospitalization, or underlying cognitive problems such as dementia are predisposing for delirium. In some studies it has been shown that delirium lengthens the hospitalization of elderly people, increases expenditures for the health services, causes an increase in functional and cognitive problems and increases mortality. In this study, our aim was to evaluate the effect of delirium on mortality in geriatric patients diagnosed with delirium by Consultation-Liaison of Psychiatry (CLP).
Methods: Files of patients aged 65 years or older were evaluated between January 2005 and December 2013 by CLP field of science retrospectively. Information on a total of 1435 patients was collected. The effect of delirium on mortality was tested by log-rank method. The effects of variants such as age, gender and chronic diseases on mortality were examined by Cox regression analysis, univariate analysis was made firstly and multivariate analysis was performed on the parameters with significant singular analysis.
Results: Prevalence of delirium was determined as 25.5%. It was determined that delirium is seen more frequently in males and these males were older and a significant difference was observed among these (p=0.000, p=0.000 respectively), but no significant difference was found when the hospitalization days were considered (p=0.214). A significant difference was observed on mortality in the first, second, third, fourth and fifth years between the two groups with or without delirium diagnosis (p<0.0001). Univariate analysis was performed to investigate the effect of diseases on mortality; the parameters with significant results in univariate analysis (age, gender, lower urinary system disease, chronic lung disease, solid hematological malignancy, infections, Alzheimer’s disease) were multivariately analyzed. In the multivariate analysis, it was observed that delirium constituted a risk factor for mortality independent from other diseases and demographical data such as age and gender.
Conclusion: In our study it was shown that delirium is a factor increasing mortality