Hospitalization days and infections as mortality indicators of delirium: More time is better?

Abstract

Introduction: Delirium is the main cause of hospitalization in elderly; infections perpetuate delirium; however, surgical wounds, urinary tract infection (UTI), pneumonia, and hematologic infections are the main causes. Aim: The aim of the study was to compare long hospital stay days versus duration of delirium as a predictor of mortality in patients with delirium and infections related. Methods: A total of 328 patients were admitted with hyperactive, hypoactive, or mixed delirium diagnosis, of which only 121 patients had positive cultures. Receiver operating characteristic curve was performed to obtain sensitivity of delirium related to mortality and Kaplan-Meier plot showing mortality of patients according to infections and delirium. Results: Mortality increases in patients with delirium, associated with UTI as a principal factor; wound infections and pneumonia were the most lethal. Delirium increases mortality during the 6-10 days, with better sensitivity predicting death compared to days of hospital stay. Escherichia colli was mostly involved, and responsible for 67% lethality, compared to Aeromonas/Citrobacter with 100% of lethality, and Acinetobacter baumannii with 75% of lethality. Conclusions: Delirium impacts negatively on the survival of patients, UTI is the main responsible of delirium and is related with the lowest mortality; prophylactic antibiotics are not recommended, because there is no reduction in mortality and frequency of delirium.

Keywords

• Infections. Mortality. Delirium. Hospitalizations.