Age and Ageing, Vol 28, 115-119, Copyright © 1999 by British Geriatrics Society
ST O'Keeffe and JN Lavan
OBJECTIVE: to examine the relative frequency and outcome of clinical
subtypes of delirium in older hospital patients. DESIGN: prospective
observational study. SETTING: acute geriatric unit in a teaching hospital.
SUBJECTS: 94 patients with delirium from a prospective study of 225
admissions. MEASUREMENTS: clinical subtypes of delirium were determined
according to predefined criteria. Characteristics examined in these
subgroups included illness severity on admission, prior cognitive
impairment, mortality, duration of hospital stay and hospital- acquired
complications. RESULTS: of the 94 patients, 20 (21%) had a hyperactive
delirium, 27 (29%) had a hypoactive delirium, 40 (43%) had a mixed
hypoactive-hyperactive psychomotor pattern and seven (7%) had no
psychomotor disturbance. There were significant differences between the
four groups in illness severity (P < 0.05), length of hospital stay (P
< 0.005) and frequency of falls (P < 0.05). Patients with hypoactive
delirium were sicker on admission, had the longest hospital stay and were
most likely to develop pressure sores. Patients with hyperactive delirium
were most likely to fall in hospital. There were no differences in
aetiological factors between the groups. CONCLUSION: outcomes of
hospitalization differ in different clinical subtypes of delirium.
ARTICLES
Clinical significance of delirium subtypes in older people
Department of Geriatric Medicine, St Michael's Hospital, Dun Laoghaire, Co. Dublin, Ireland.
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