L Lázaro1, T Marcos, E Cirera, J Pujol. 1. Subdivisión de Psiquiatría y Psicología Médica, Hospital Clínic i Provincial, Barcelona.
Abstract
BACKGROUND: Delirium is an organic mental disorder frequently seen in elderly patients admitted to hospital for medical or surgical diseases. The prevalence, triggering factors, the relationship with prior existence of dementia and the evolution of delirium were studied. METHODS: One hundred eight elderly patients admitted to the Internal Medicine, General Surgery and Traumatology Departments of the Hospital Clínic i Provincial in Barcelona, Spain were randomly selected with clinical evaluation being performed following the DSM-III-R diagnostic criteria. Likewise a structured clinical interview (CAMDEX) was carried out, and the establishment of delirium, the possible causes and its evolution were evaluated. RESULTS: Eighteen of the elderly patients studied presented delirium at some time during hospital stay. Of these patients 15 had previously been clinically diagnosed with dementia. These patients did not require longer hospital stay than those not presenting dementia. The most frequent etiology was surgery and fever due to an infectious process. In addition to etiologic treatment, 12 of the patients also received symptomatic treatment with a neuroleptic drug (haloperidol). CONCLUSIONS: Most of the elderly who have presented delirium admitted in a general hospital had been diagnosed with dementia during hospital stay thus indicating the high comorbidity of the two entities. In many cases it is important to carry out symptomatic in addition to etiologic treatment to achieve rapid reversibility of the disorder.
BACKGROUND:Delirium is an organic mental disorder frequently seen in elderly patients admitted to hospital for medical or surgical diseases. The prevalence, triggering factors, the relationship with prior existence of dementia and the evolution of delirium were studied. METHODS: One hundred eight elderly patients admitted to the Internal Medicine, General Surgery and Traumatology Departments of the Hospital Clínic i Provincial in Barcelona, Spain were randomly selected with clinical evaluation being performed following the DSM-III-R diagnostic criteria. Likewise a structured clinical interview (CAMDEX) was carried out, and the establishment of delirium, the possible causes and its evolution were evaluated. RESULTS: Eighteen of the elderly patients studied presented delirium at some time during hospital stay. Of these patients 15 had previously been clinically diagnosed with dementia. These patients did not require longer hospital stay than those not presenting dementia. The most frequent etiology was surgery and fever due to an infectious process. In addition to etiologic treatment, 12 of the patients also received symptomatic treatment with a neuroleptic drug (haloperidol). CONCLUSIONS: Most of the elderly who have presented delirium admitted in a general hospital had been diagnosed with dementia during hospital stay thus indicating the high comorbidity of the two entities. In many cases it is important to carry out symptomatic in addition to etiologic treatment to achieve rapid reversibility of the disorder.