Delirium associated with premature death

Patients who are delirious during hospitalization one year later had 13 percent fewer days of survival during the following year when compared to patients without delirium, according to a study published this month in the Archives of Internal Medicine.

Delirium is a frequent problem for hospitalized older patients with consequences ranging from increased morbidity and mortality, persistent functional decline and increased and costlier hospital stay to higher rates of nursing home placement, increased caregiver burden, and overall higher health care costs, the researchers said.

Previous studies demonstrated an increased risk of mortality associated with delirium, but little was known about the mortality time course. The objective of this study was to estimate the fraction of a year of life lost associated with delirium at a one-year follow up. The study included 919 patients 70 and older who participated in an earlier study on delirium prevention intervention. Of these patients, 115 had delirium during their hospital stay.

“Patients with delirium survived 274 days on average compared with 321 days for patients without delirium, representing a difference of 13 percent a year,” said Douglas Leslie, assistant professor of psychiatry at Yale School of Medicine.

He said the finding of premature mortality associated with delirium illustrates the need to design longer lasting interventions after a patient is released from the hospital.

Co-authors include Ying Zhang, M.D., Theodore Holford, Sidney Bogardus, M.D., and Linda Leo-Summers. The senior author was Sharon Inouye, M.D.