Mario Bo1, Paola Porrino2, Simona G Di Santo3, Andrea Mazzone4, Antonio Cherubini5, Enrico Mossello6, Angelo Bianchetti7, Massimo Musicco8,9, Alberto Ferrari10, Nicola Ferrara11, Claudia Filippini12, Marco Trabucchi13,14, Alessandro Morandi15, Giuseppe Bellelli16,17. 1. Section of Geriatrics, Città della Salute e della Scienza, Molinette, Corso Bramante, 88, 10126, Torino, Italy. 2. Section of Geriatrics, Città della Salute e della Scienza, Molinette, Corso Bramante, 88, 10126, Torino, Italy. paolapo1985@yahoo.it. 3. Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCCS Fondation S Lucia, Via Ardeatina, 306-354, 00179, Roma, Italy. 4. Redaelli Geriatric Institute, Via Bartolomeo d'Alviano, 78, 20146, Milano, Italy. 5. Geriatrics and Geriatric Emergency Care, IRCCS-INRCA, Via della Montagnola, 81, 60127, Ancona, Italy. 6. Research Unit of Medicine of Ageing, Department of Experimental and Clinical Medicine, University of Florence and AziendaOspedaliero-UniversitariaCareggi, Largo Brambilla, 3a, 50134, Firenze, Italy. 7. Medicine and Rehabilitation Department, IstitutoClinico S. Anna, Via del Franzone, 31, 25127, Brescia, Italy. 8. Institute of Biomedical Technologies, National Research Council, Via Fratelli Cervi 93, Segrate, 20090, Milano, Italy. 9. Italian Society of Neurology for Dementia (SINDEM), via del Rastrello, 7, 53100, Siena, Italy. 10. Italian Society of Hospital and Community Geriatrics (SIGOT), Roma, Italy. 11. Department of Translational Medical Sciences, Federico II University of Naples, Corso Umberto I 40, 80138, Napoli, Italy. 12. Department of Surgical Sciences, University of Turin, Corso Bramante, 88, 10126, Torino, Italy. 13. Geriatric Research Group, via Fratelli Lombardi, 2, 25121, Brescia, Italy. 14. Italian Psychogeriatric Association (AIP), Via Fratelli Lombardi, 2, 25121, Brescia, Italy. 15. Department of Rehabilitation and Aged Care "Fondazione Camplani" Hospital, Via Aselli, 14, 26100, Cremona, Italy. 16. School of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milano, Italy. 17. Geriatric Unit, San Gerardo University Hospital, Via G. B. Pergolesi, 33, 20900, Monza, Italy.
Abstract
BACKROUND: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. AIM: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. METHODS: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4: possible delirium; scores 1-3: possible cognitive impairment). RESULTS: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. DISCUSSION: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. CONCLUSION: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence.
BACKROUND: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. AIM: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. METHODS: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4: possible delirium; scores 1-3: possible cognitive impairment). RESULTS: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. DISCUSSION: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. CONCLUSION: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence.
Authors: Chiara Muzzana; Franco Mantovan; Markus Karl Huber; Katia Trevisani; Sarah Niederbacher; Alexander Kugler; Dietmar Ausserhofer Journal: Nurs Open Date: 2022-06-18