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Archivos de Medicina Interna

Print version ISSN 0250-3816On-line version ISSN 1688-423X


LLORENS, Mario et al. Clinical features of the Delirium Syndrome in a general hospital: risk factors and triggering factors. Arch. Med Int [online]. 2009, vol.31, n.4, pp.93-98. ISSN 0250-3816.

SUMMARY: Interna 2009 - XXXI;4:93-98 Aims: to assess the prevalence of delirium in hospitalized patients in a general hospital. To identify risk factors and most frequent triggering factors. To compare hospital length of stay and mortality in patients with or without delirium. Material and methods: transversal observational study of hospitalized patients. Assessment method for the intensive care (CAM-ICu) was used as a tool for diagnosis of delirium. We compared the risk factors of patients with and without delirium. The triggering factors were categorized according to DSM-IV-TR criteria. Results: 505 patients were enrolled, 40 were excluded. 465 patients were analized. The prevalence of delirium was 7.5%. In the bivariate analysis the risk factors that showed a significant association with delirium were: more than 65 years old (p=0.04), previous cognitive deterioration (p<0.001), chronic encephalopathy (p<0.001), polypharmacy (p=0.03), and hypoalbuminemia (p<0.001). In the logistic regression analysis, the associated risk factors were: previous cognitive decline OR 13.42; CI 4.69-38.3 (p<0.001) and chronic encephalopathy OR 5.40; CI 1,78-14.97 (p=0.003). Triggering factors: illness 77%, multiple etiologies 20%, intoxication by substances 3%. In 28% of cases the medical cause was infectious. Mortality in patients without delirium: 11.4%. Mortality in patients with delirium 34.3%. Discussion and comments: the observed prevalence is similar to the one observed in other studies. The most frequent risk factor was previous cognitive deterioration and the most common triggering factor was infection disease. The mortality in patient with delirium was higher than the mortality in patient without it. By identifying the risk and triggering factors prevention strategies may be settied.

Keywords : Delirium; Prevalence; Risk factors; Triggering factors; Mortality.

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