Delirium in hospitalized patients: Cohort observational in infirmary of medical clinic


Objectives: To determine prevalence, incidence and risk factors of delirium in hospitalized patients in the infirmary of medical clinic of the Lauro Wanderley University Hospital. Method: An observational cohort study evaluating 140 patients over 18 years between admission and discharge. The survey instrument was the Confusion Assessment Method. Results: The prevalence of delirium was 5.7% (8/140) and the incidence, 2.1%. In patients with delirium were observed alteration of sleep-wake cycle (6/75%), altered level of consciousness (6/75%), disorganized thinking (5/62, 5%) and psychomotor retardation (5/62 5%). There was a significant association of delirium and age, mechanical restraint in bed, prior history of cognitive impairment, auditory and visual sensory deficit, psychiatric hospitalization, poor health status and mortality. Conclusions: The prevalence of delirium at admission was lower than that found in other studies, but it was a predictor factor of hospital mortality.

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Sousa-Muñoz, R. , Taguchi, L. , Andrade, M. and Lima, K. (2012) Delirium in hospitalized patients: Cohort observational in infirmary of medical clinic. Open Journal of Preventive Medicine, 2, 190-195. doi: 10.4236/ojpm.2012.22028.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] González, M., Pablo, J. and Valdés, M. (2003). Delirium: La confusión de los clínicos. La Revista Médica de Chile, 131, 1051-1060.
[2] Homsi, J. and Luong, D. (2007) Symptoms and survival in patients with advanced disease. Journal of Palliative Medicine, 10, 904-909. doi:10.1089/jpm.2007.0004
[3] Wacker, P., Nunes, P. V. and Forlenza, O. V. (2005) Delirium: Uma perspectiva histórica. Revista de Psiquiatria Clínica, 32, 97-103.
[4] Rudberg, M.A., Pompei, P., Foreman, M.D., Ross, R.E. and Cassel, C.K. (1997) The natural history of delirium in older hospitalized patients: A syndrome of heterogeneity. Age Aging, 26, 169-174. doi:10.1093/ageing/26.3.169
[5] Cole, M.G. and Primeau, F.J. (1996) Prognosis of delirium in elderly hospital patients. Canadian Medical Association Journal, 149, 41-46.
[6] Inouye, S.K., van Dick, C.H., Alessi, C.A., Balkin, S., Siegal, A.P. and Horwitz, M.I. (1990). Clarifying confusion: The confusion assessment method. A new method for detection of delirium. Annals of Internal Medicine, 113, 941-948.
[7] Organiza??o Mundial da Saúde (1997) Classifica??o Estatística Internacional de Doen?as e Problemas Relacionados à Saúde. Universidade de S?o Paulo, S?o Paulo.
[8] Fabri, R.M.A., Moreira, G.R. and Almeida, O.P. (2001). Valida??o e confiabilidade da vers?o em língua portuguesa do confusion assessment method (CAM) para a detec??o de delirium no idoso. Arquivos de Neuro-Psiquiatria, 59, 175-179.
[9] Sousa-Mu?oz, R.L., Maroja, J.L.S., Cunha, G.N., Trocolli, M.S. and Barbosa, J.A.D. (2005). Detec??o clínica de consumo alcoólico em pacientes internados no hospitalescola da UFPB. Revista Brasileira de Medicina, 62, 387- 390.
[10] Chávez-Delgado, M.E., Virgen-Enciso, N., Peréz-Guzman, J., Celis-de-La-Rosa, A. and Castro-Casta?eda, S. (2007). Detection of delirium in hospitalized elderly patients using the confusion as-sessment method. Revista Medica del Instituto Mexicano del Seguro Social, 45, 321-328.
[11] Pompei, P., Foreman, M., Ynouye, S.K. and Braund, V. (1994). Delirium in hospitalized older persons: outcomes and predictors. Journal of the American Geriatrics Society, 42, 809-815.
[12] Inouye, S.K. (2006) Delirium in older persons. The New England Journal of Medicine, 354, 1157-1165. doi:10.1056/NEJMra052321
[13] Thomas, R.I., Cameron, D.J. and Facs, M.C. (1988). A prospective study of delirium and prolonged hospital stay. Exploratory study. Archives of General Psychiatry, 45, 937-940. doi:10.1001/archpsyc.1988.01800340065009
[14] Ouimet, S., Kavanagh, B.P., Gottfried, S.B. and Skrobik, Y. (2006). Incidence, risk factors and consequences of ICU delirium. Intensive Care Medicine, 33, 66-73. doi:10.1007/s00134-006-0399-8
[15] Elie, M., Rousseau, F., Cole, M., Primeau, F., MacKusker, J. and Bellavance, F. (2000). Prevalence and detection of delirium in elderly emergency department patients. Canadian Medical Association Journal, 163, 977-981.
[16] Zou, Y. (1998). Detection and diagnosis of delirium in the elderly: Psychiatrist diagnosis, confusion assessment method, or consensus diagnosis? International Psychogeriatrics, 19, 303-308. doi:10.1017/S1041610298005390
[17] Fann, J.R. (2000). The epidemiology of delirium: A review of studies and methodological issues. Seminars in Clinical Neuropsy-chiatry, 5, 64-74.
[18] Inouye, S.K. (1999). Predisposing and precipitating factors for delirium in hospitalized older patients. Dementia and Geriatric Cognitive Disorders, 10, 393-400. doi:10.1159/000017177
[19] Inouye, S.K., Rushing, J.T., Foreman, M.D., Palmer, R. M. and Pompei, P. (1998) Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. Journal of General Internal Medicine, 340, 669-676.
[20] Conn, D.F. and Lieff, S. (2001). Diagnosing and managing delirium in the elderly. Canadian Family Physician, 47, 101-108.
[21] Inouye, S.K., Zhang, Y., Jones, R.N., Kiely, D.K., Yank, F. and Marcantonio, E.R. (2007). Delirium at discharge: Development and validation of a predictive model. Archives of Internal Medicine, 13, 1406-1413. doi:10.1001/archinte.167.13.1406
[22] Chavéz-Delgado, M.E., Virgen-Enciso, M., Perez-Guzmán, J., Celis-de-la-Rosa, A. and Castro-Casta?eda, S. (2007). Detection of delirium in hospitalized elderly patients using the confusion assessment method. Revista Medica del Instituto Mexicano del Seguro Social, 45, 321-328.
[23] Santos. F.S. (2005). Mecanismos fisiopatológicos do delirium. Revista de Psiquiatria Clinica, 32, 104-112. doi:10.1590/S0101-60832005000300002
[24] Stevens, L.E., De Moore, G.M. and Simpson, M. (1998) Delirium in hospital: does it increase length of stay? Australian and New Zealand Journal of Psychiatry, 32, 805-808. doi:10.3109/00048679809073869
[25] O’Keefe, S.L. and Lavan, J. (1997). The prognostic significance of delirium in older patients. Journal of the American Geriatrics Society, 45, 174-178.
[26] Mittal, D., Majithia, D., Keneth, R. and Ruddy, J. (2006). Differences in characteristics and outcome of delirium as based on referral patterns. Psychosomatics, 47, 367-375. doi:10.1176/appi.psy.47.5.367

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