P128: The Valladolid Multicentre Study: Delirium characteristics in patients attended in seven liaison psychiatry services in Spain.

Abstract

Introduction and objective:

Delirium is an acute and fluctuating disorder characterized by a disturbance in attention and cognition that is commonly observed in hospitalized older adults; being present in up to 23% of patients admitted to a general medical service and as many as 85% of patients in the intensive care unit. Delirium causes complications such as increased morbidity, persistent functional decline, mortality, increased frailty and increased length of hospital stay. Nonetheless, it is often underdiagnosed, especially when it occurs in its hypoactive form. The objective of this study is to describe characteristics and factors associated with the presence of delirium in patients ≥65 years treated by the liaison psychiatric units in seven general hospitals.

Methods:

This is an observational, cross-sectional, multicentre study. We obtained data from a sample of 165 patients (≥65 years) admitted to seven general hospitals in Spain referred from different departments to each liaison psychiatry unit. Data was collected for a month and a half period. Psychiatric evaluations were performed while the patients were on wards.

Results:

We obtained a sample of 165 patients (78 women, 88 men) with a mean age of 76,03 years old (42.10% <75 years, 57,83% ≥ 75 years). Most of them were married and they lived accompanied (67,27%). Delirium was diagnosed in 20% of the consultations. A multivariate analysis was developed with the presence of delirium as the independent variable. The nature of the underlying pathology, the presence of a previous mental disorder, functionality using the Barthel and Lawton Brody Indexes and the prescribed pharmacological treatments were used as dependent variables. Cohen’s kappa statistics were used to estimate the agreement between delirium diagnose made by psychiatrists and the diagnoses considered by the referring doctors. Low agreement was found for the presence of delirium (Kappa= 0,2341). We also explored the relationship between the presence of delirium and the mean length of stay, as well as the discharge destination of these patients.

Conclusions:

There are still many difficulties in the diagnosis and treatment of patients with delirium. Better knowledge of the factors associated with its appearance would improve the management of these patients.