Predisposing and precipitating risk factors for delirium in elderly patients admitted to a cardiology ward : an observational cohort study in 1,042 patients

Zipser, Carl Moritz; Hildenbrand, Florian Freimut; Haubner, Bernhard; Deuel, Jeremy; Ernst, Jutta; Petry, Heidi; Schubert, Maria; Jordan, Katja-Daniela; von Känel, Roland; Boettger, Soenke

doi:10.3389/fcvm.2021.686665

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-23386

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Predisposing and precipitating risk factors for delirium in elderly patients admitted to a cardiology ward : an observational cohort study in 1,042 patients
Authors:	Zipser, Carl Moritz Hildenbrand, Florian Freimut Haubner, Bernhard Deuel, Jeremy Ernst, Jutta Petry, Heidi Schubert, Maria Jordan, Katja-Daniela von Känel, Roland Boettger, Soenke
et. al:	No
DOI:	10.3389/fcvm.2021.686665 10.21256/zhaw-23386
Published in:	Frontiers in Cardiovascular Medicine
Volume(Issue):	8
Issue:	686665
Issue Date:	Sep-2021
Publisher / Ed. Institution:	Frontiers Research Foundation
ISSN:	2297-055X
Language:	English
Subjects:	Cardiology; Delirium; Personalized medicine; Precipitating factor; Predisposing factor
Subject (DDC):	616: Internal medicine and diseases
Abstract:	Aim: Although the risk factors for delirium in general medicine are well-established, their significance in cardiac diseases remains to be determined. Therefore, we evaluated the predisposing and precipitating risk factors in patients hospitalized with acute and chronic heart disease. Methods and Results: In this observational cohort study, 1,042 elderly patients (≥65 years) admitted to cardiology wards, 167 with and 875 without delirium, were included. The relevant sociodemographic and cardiac- and medical-related clusters were assessed by simple and multiple regression analyses and prediction models evaluating their association with delirium. The prevalence of delirium was 16.0%. The delirious patients were older (mean 80 vs. 76 years; p < 0.001) and more often institutionalized prior to admission (3.6 vs. 1.4%, p = 0.05), hospitalized twice as long (12 ± 10 days vs. 7 ± 7 days; p < 0.001), and discharged more often to nursing homes (4.8 vs. 0.6%, p < 0.001) or deceased (OR, 2.99; 95% CI, 1.53-5.85; p = 0.003). The most relevant risk factor was dementia (OR, 18.11; 95% CI, 5.77-56.83; p < 0.001), followed by history of stroke (OR, 6.61; 95% CI 1.35-32.44; p = 0.020), and pressure ulcers (OR, 3.62; 95% CI, 1.06-12.35; p = 0.040). The predicted probability for developing delirium was highest in patients with reduced mobility and institutionalization prior to admission (PP = 31.2%, p = 0.001). Of the cardiac diseases, only valvular heart disease (OR, 1.57; 95% CI, 1.01-2.44; p = 0.044) significantly predicted delirium. The patients undergoing cardiac interventions did not have higher rates of delirium (OR, 1.39; 95% CI 0.91-2.12; p = 0.124). Conclusion: In patients admitted to a cardiology ward, age-related functional and cognitive impairment, history of stroke, and pressure ulcers were the most relevant risk factors for delirium. With regards to specific cardiological factors, only valvular heart disease was associated with risk for delirium. Knowing these factors can help cardiologists to facilitate the early detection and management of delirium.
URI:	https://digitalcollection.zhaw.ch/handle/11475/23386
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Health Sciences
Organisational Unit:	Institute of Nursing (IPF)
Appears in collections:	Publikationen Gesundheit

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Zipser, C. M., Hildenbrand, F. F., Haubner, B., Deuel, J., Ernst, J., Petry, H., Schubert, M., Jordan, K.-D., von Känel, R., & Boettger, S. (2021). Predisposing and precipitating risk factors for delirium in elderly patients admitted to a cardiology ward : an observational cohort study in 1,042 patients. Frontiers in Cardiovascular Medicine, 8(686665). https://doi.org/10.3389/fcvm.2021.686665

Zipser, C.M. et al. (2021) ‘Predisposing and precipitating risk factors for delirium in elderly patients admitted to a cardiology ward : an observational cohort study in 1,042 patients’, Frontiers in Cardiovascular Medicine, 8(686665). Available at: https://doi.org/10.3389/fcvm.2021.686665.

C. M. Zipser et al., “Predisposing and precipitating risk factors for delirium in elderly patients admitted to a cardiology ward : an observational cohort study in 1,042 patients,” Frontiers in Cardiovascular Medicine, vol. 8, no. 686665, Sep. 2021, doi: 10.3389/fcvm.2021.686665.

ZIPSER, Carl Moritz, Florian Freimut HILDENBRAND, Bernhard HAUBNER, Jeremy DEUEL, Jutta ERNST, Heidi PETRY, Maria SCHUBERT, Katja-Daniela JORDAN, Roland VON KÄNEL und Soenke BOETTGER, 2021. Predisposing and precipitating risk factors for delirium in elderly patients admitted to a cardiology ward : an observational cohort study in 1,042 patients. Frontiers in Cardiovascular Medicine. September 2021. Bd. 8, Nr. 686665. DOI 10.3389/fcvm.2021.686665

Zipser, Carl Moritz, Florian Freimut Hildenbrand, Bernhard Haubner, Jeremy Deuel, Jutta Ernst, Heidi Petry, Maria Schubert, Katja-Daniela Jordan, Roland von Känel, and Soenke Boettger. 2021. “Predisposing and Precipitating Risk Factors for Delirium in Elderly Patients Admitted to a Cardiology Ward : An Observational Cohort Study in 1,042 Patients.” Frontiers in Cardiovascular Medicine 8 (686665). https://doi.org/10.3389/fcvm.2021.686665.

Zipser, Carl Moritz, et al. “Predisposing and Precipitating Risk Factors for Delirium in Elderly Patients Admitted to a Cardiology Ward : An Observational Cohort Study in 1,042 Patients.” Frontiers in Cardiovascular Medicine, vol. 8, no. 686665, Sept. 2021, https://doi.org/10.3389/fcvm.2021.686665.