Impact of Polypharmacy on Occurrence of Delirium in Elderly Emergency Patients |
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| Affiliation: | 1. Gérontopôle, Service de Médecine Interne Gériatrique, CHU Toulouse Hôpital Casselardit, Toulouse, France;2. Pharmacologie Clinique, Faculté de Médecine, Toulouse, France;3. Inserm U1027, Faculté de médecine 37, Toulouse, France;1. TCD/HSE Specialist Training in General Practice, Dublin, Ireland;2. Department of Age Related Healthcare, Tallaght Hospital, Dublin, Ireland;3. School of Medicine, Trinity College, Dublin, Ireland;4. Department of Medical Gerontology, Trinity College Dublin School of Medicine, Dublin, Ireland;1. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;2. Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA;3. Leiden University Medical Center, Leiden, Netherlands;4. Leyden Academy on Vitality and Ageing, Leiden, Netherlands;5. Division of Geriatric Medicine and Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA;1. School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia;2. School of Pharmacy, The University of Queensland, Brisbane, Australia;3. Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia;1. Department of Nursing, Chinese Academy of Medical Sciences–Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China;2. Shenzhen Second People''s Hospital, Shenzhen, China |
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| Abstract: | ObjectiveTo examine associations between polypharmacy and delirium diagnosed in elderly patients hospitalized in geriatric acute care unit after emergency hospital admission.MethodsStudy design was an observational cohort study in the acute geriatric care unit of a university hospital. We included 410 consecutive patients admitted to the acute geriatric ward during 9 months. Within 72 hours of each patient's hospitalization, a clinically trained geriatrician collected the following data: sociodemographic details (age, sex, type of residence), predisposing factors for delirium, main cause of hospitalization, and current medications. Polypharmacy was defined as 6 or more drugs a day. Delirium was assessed by a geriatrician using the Confusion Assessment Method and was diagnosed on the basis of clinical history with an acute change in usual functional status, behavioral observation, and clinical and cognitive assessment.ResultsNearly 25% of hospitalized patients had delirium. The Confusion Assessment Method was positive in 69% of patients receiving polypharmacy and in 30% of those not receiving polypharmacy, a relative risk of 2.33. The proportion of elderly patients receiving polypharmacy was 58.53%.ConclusionsIn our study, polypharmacy is an independent risk factor for delirium in a population of elderly patients after emergency admission. In the geriatric population, delirium is an underestimated scourge and because of its medicosocial and economic consequences and its impact on morbidity and mortality, we need to give increased attention to the prevention and control of polypharmacy, which is a predisposing factor for delirium. |
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| Keywords: | Polypharmacy delirium elderly geriatrics drug-induced delirium |
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