Delirium in internal medicine ward – impact on clinical practice
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i4p357-365Keywords:
Delirium, Internal medicine, Aged, MortalityAbstract
Introduction: Delirium is common in hospitalized elderly patients. It is defined as an acute and fluctuating, usually reversible, alteration of the level of cognition, attention and consciousness, with a multifactorial etiology, associated with increased morbimortality and costs, however, remains underdiagnosed. We evaluated the occurrence of delirium in an Internal Medicine ward, it’s main risk factors and consequences during hospitalization and 3 months after discharge. Materials and Methods: prospective 3-month observational study in a ward of a tertiary hospital, using the adaptation of Richmond sedation and agitation scale and the Confusion Assessment Method for the diagnosis of delirium, confirmed by the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. The main risk factors were selected according to the guidelines. Hospitalization consequences and survival at 3 months were evaluated. Results/Discussion: In a sample of 297 patients, 26% presented delirious, mostly at admission (73%), with a hyperactive phenotype (50%). These patients were older, with more comorbidities, namely dementia, and less autonomy. Physical restraint, autonomy impairment, and serum potassium levels were identified as independent factors for delirium. It was also associated with higher in-hospital and 3 months mortality, and major burden on health professionals. The application of the scales allowed a greater recognition of this syndrome (12% to 26%), namely the hypoactive forms. Conclusion: Delirium was frequent and with a high impact on patients and health professionals.
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