Gabriel Fernando Oviedo Lugo , Paola Andrea García Martínez , Andrés Duarte Osorio , Carlos Javier Rincón , Alejandra López , Roberto Chavarría , Catalina Pineda Betancur , Natalia García Gil , María Natalia Duarte Ariza , Juan Agustín Patiño Trejos , Juan Sebastián Insignares , Carlos Gómez-Restrepo
{"title":"拉丁美洲一所大学医院的迷惑综合征（谵妄）发病率。","authors":"Gabriel Fernando Oviedo Lugo , Paola Andrea García Martínez , Andrés Duarte Osorio , Carlos Javier Rincón , Alejandra López , Roberto Chavarría , Catalina Pineda Betancur , Natalia García Gil , María Natalia Duarte Ariza , Juan Agustín Patiño Trejos , Juan Sebastián Insignares , Carlos Gómez-Restrepo","doi":"10.1016/j.rcpeng.2022.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Little is known about the incidence of delirium and its subtypes in patients admitted to different departments of university hospitals in Latin America.</p></div><div><h3>Objective</h3><p>To determine the incidence of delirium and the frequency of its subtypes, as well as its associated factors, in patients admitted to different departments of a university hospital in Bogotá, Colombia.</p></div><div><h3>Methods</h3><p>A cohort of patients over 18 years of age admitted to the internal medicine (IM), geriatrics (GU), general surgery (GSU), orthopaedics (OU) and intensive care unit (ICU) services of a university hospital was followed up between January and June 2018. To detect the presence of delirium, we used the CAM (Confusion Assessment Method) and the CAM-ICU if the patient had decreased communication skills. The delirium subtype was characterised using the RASS (Richmond Agitation and Sedation Scale). Patients were assessed on their admission date and then every two days until discharged from the hospital. Those in whom delirium was identified were referred for specialised intra-institutional interdisciplinary management.</p></div><div><h3>Results</h3><p>A total of 531 patients admitted during the period were assessed. The overall incidence of delirium was 12% (95% CI, 0.3–14.8). They represented 31.8% of patients in the GU, 15.6% in the ICU, 8.7% in IM, 5.1% in the OU, and 3.9% in the GSU. The most frequent clinical display was the mixed subtype, at 60.9%, followed by the normoactive subtype (34.4%) and the hypoactive subtype (4.7%). The factors most associated with delirium were age (adjusted RR = 1.07; 95% CI, 1.05−1.09), the presence of four or more comorbidities (adjusted RR = 2.04; 95% CI, 1.31−3.20), and being a patient in the ICU (adjusted RR = 2.02; 95% CI, 1.22−3.35).</p></div><div><h3>Conclusions</h3><p>The incidence of delirium is heterogeneous in the different departments of the university hospital. The highest incidence occurred in patients that were admitted to the GU. The mixed subtype was the most frequent one, and the main associated factors were age, the presence of four or more comorbidities, and being an ICU patient.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"53 1","pages":"Pages 41-46"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidence of confusional syndrome (delirium) in a Latin American university hospital\",\"authors\":\"Gabriel Fernando Oviedo Lugo , Paola Andrea García Martínez , Andrés Duarte Osorio , Carlos Javier Rincón , Alejandra López , Roberto Chavarría , Catalina Pineda Betancur , Natalia García Gil , María Natalia Duarte Ariza , Juan Agustín Patiño Trejos , Juan Sebastián Insignares , Carlos Gómez-Restrepo\",\"doi\":\"10.1016/j.rcpeng.2022.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Little is known about the incidence of delirium and its subtypes in patients admitted to different departments of university hospitals in Latin America.</p></div><div><h3>Objective</h3><p>To determine the incidence of delirium and the frequency of its subtypes, as well as its associated factors, in patients admitted to different departments of a university hospital in Bogotá, Colombia.</p></div><div><h3>Methods</h3><p>A cohort of patients over 18 years of age admitted to the internal medicine (IM), geriatrics (GU), general surgery (GSU), orthopaedics (OU) and intensive care unit (ICU) services of a university hospital was followed up between January and June 2018. To detect the presence of delirium, we used the CAM (Confusion Assessment Method) and the CAM-ICU if the patient had decreased communication skills. The delirium subtype was characterised using the RASS (Richmond Agitation and Sedation Scale). Patients were assessed on their admission date and then every two days until discharged from the hospital. Those in whom delirium was identified were referred for specialised intra-institutional interdisciplinary management.</p></div><div><h3>Results</h3><p>A total of 531 patients admitted during the period were assessed. The overall incidence of delirium was 12% (95% CI, 0.3–14.8). They represented 31.8% of patients in the GU, 15.6% in the ICU, 8.7% in IM, 5.1% in the OU, and 3.9% in the GSU. The most frequent clinical display was the mixed subtype, at 60.9%, followed by the normoactive subtype (34.4%) and the hypoactive subtype (4.7%). The factors most associated with delirium were age (adjusted RR = 1.07; 95% CI, 1.05−1.09), the presence of four or more comorbidities (adjusted RR = 2.04; 95% CI, 1.31−3.20), and being a patient in the ICU (adjusted RR = 2.02; 95% CI, 1.22−3.35).</p></div><div><h3>Conclusions</h3><p>The incidence of delirium is heterogeneous in the different departments of the university hospital. The highest incidence occurred in patients that were admitted to the GU. The mixed subtype was the most frequent one, and the main associated factors were age, the presence of four or more comorbidities, and being an ICU patient.</p></div>\",\"PeriodicalId\":74702,\"journal\":{\"name\":\"Revista Colombiana de psiquiatria (English ed.)\",\"volume\":\"53 1\",\"pages\":\"Pages 41-46\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Colombiana de psiquiatria (English ed.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2530312024000080\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Colombiana de psiquiatria (English ed.)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2530312024000080","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Incidence of confusional syndrome (delirium) in a Latin American university hospital
Background
Little is known about the incidence of delirium and its subtypes in patients admitted to different departments of university hospitals in Latin America.
Objective
To determine the incidence of delirium and the frequency of its subtypes, as well as its associated factors, in patients admitted to different departments of a university hospital in Bogotá, Colombia.
Methods
A cohort of patients over 18 years of age admitted to the internal medicine (IM), geriatrics (GU), general surgery (GSU), orthopaedics (OU) and intensive care unit (ICU) services of a university hospital was followed up between January and June 2018. To detect the presence of delirium, we used the CAM (Confusion Assessment Method) and the CAM-ICU if the patient had decreased communication skills. The delirium subtype was characterised using the RASS (Richmond Agitation and Sedation Scale). Patients were assessed on their admission date and then every two days until discharged from the hospital. Those in whom delirium was identified were referred for specialised intra-institutional interdisciplinary management.
Results
A total of 531 patients admitted during the period were assessed. The overall incidence of delirium was 12% (95% CI, 0.3–14.8). They represented 31.8% of patients in the GU, 15.6% in the ICU, 8.7% in IM, 5.1% in the OU, and 3.9% in the GSU. The most frequent clinical display was the mixed subtype, at 60.9%, followed by the normoactive subtype (34.4%) and the hypoactive subtype (4.7%). The factors most associated with delirium were age (adjusted RR = 1.07; 95% CI, 1.05−1.09), the presence of four or more comorbidities (adjusted RR = 2.04; 95% CI, 1.31−3.20), and being a patient in the ICU (adjusted RR = 2.02; 95% CI, 1.22−3.35).
Conclusions
The incidence of delirium is heterogeneous in the different departments of the university hospital. The highest incidence occurred in patients that were admitted to the GU. The mixed subtype was the most frequent one, and the main associated factors were age, the presence of four or more comorbidities, and being an ICU patient.
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