Abstract
Objective
To examine associations between polypharmacy and delirium diagnosed in elderly patients
hospitalized in geriatric acute care unit after emergency hospital admission.
Methods
Study 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.
Results
Nearly 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%.
Conclusions
In 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.
Keywords
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Article info
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
